退休及生活困难女性妇女病普查后就诊干预研究

Effect of intervention on clinic visiting rate of woman with gynecological diseases after disease census among retired or poverty-stricken women

目的评价社区医生督促就诊措施对上海市长宁区江苏社区退休及生活困难女性妇女病普查后就诊率的干预效果。方法采用前瞻性干预研究设计和整群抽样方法,利用妇科普查和入户调查相结合的方法,收集714名退休及生活困难女性相关信息进行分析。结果江苏社区2008年妇女病普查患病并接受基线随访的退休及生活困难女性共714例,普查后半年内就诊率为36.27%;社区医生上门督促后1年左右再次接受调查的共681例,就诊率为54.48%;生活困难女性基线就诊率（13.04%）低于退休女性（37.87%）;受教育程度为大专及以上或初中者督促后就诊率较高,分别为48.84%和33.33%;自感疾病严重程度和基线就诊率、督促后就诊率均呈正相关（OR=2.45,95%CI=1.82~3.30;OR=5.10,95%CI=3.21~8.10）。结论退休及生活困难女性妇女病普查检出率高,就诊率低,社区医生督促就诊对于提高就诊率有一定效果。

Objective To evaluate the effect of intervention on improving chinic visiting rate of women with gynecolological diseases after disease census among retired or poverty-stricken women in a community of Shanghai.Methods The prospective intervention study was executed in 714 subjects selected with cluster sampling from all retired or poverty-stricken women registered in the community.Data were collected through a questionnaire survey and physical examination.Results Among the 714 women with at least one gynecological disease,36.27% sought medical treatment during six months after the disease survey.After a face-to-face intervention on clinic visit by community doctor,54.48% of the women sought medical treatment.A decreased clinic visiting baseline rate was detected in the poverty-stricken women（13.04%）.An increased clinic visiting rate after the intervention of community doctor was observed in the women with education of college and above（48.84%） and middle school（33.33%）.There was a positive correlation between the self-reported severity of diseases and baseline clinic-visiting rate（odds ratio=2.45,95% confidence interval：1.82-3.30） and clinic visiting rate after the intervention（OR=5.10,95%CI：3.21-8.10）.Conclusion The prevalence rate of gynecological disease was high among retired or poverty-stricken women,but the clinic visiting rate was low.The intervention on clinic-visiting by community doctor could increase clinic-visiting rate.