山东省农村肺结核患者的首诊机构选择情况调查

Survey of first choice of medical institutions by tuberculosis patients in rural areas of Shandong Province

目的了解肺结核患者选择首次就诊机构的影响因素,以及不同首次就诊机构对诊断结果和过程的影响。方法使用回顾式问卷,调查山东省16个县（区）2009年7月~2010年6月登记的1 431例新发现结核病患者。结果 58.8%的患者首次就诊选择村医、乡镇卫生院等基层机构;83%的患者首次就诊选择非结防机构;性别对首次就诊机构的选择没有影响,年龄偏大和文化程度低的患者倾向选择基层或非结防机构。选择基层机构的患者自首次就诊至确诊经历的时间和就医次数较多。结论需要开展针对性的宣教,使患者尽早到结防机构就诊;基层机构和其它非结防机构需要提高早期诊断结核病的能力,并做好归口管理工作。

Objective To understand the factors influencing the first choice of medical institutins by tuberculosis（TB） patients.Methods Questionnaire survey of 1 431 newly rTB patients from 16 counties registered from July 2009 to June 2010.Results 58.8% of the patients firstly visited primary health facilities,and 83% chose non-TB institutions.The patients elder andd with lower education background tended to seek medical consultation in medical insititutions at grassroots level.Conclusion Targeted health education should be carried out to promote patient to seek care at TB facility voluntarily;primary health care bodies and non-TB facility should refer TB patients promptly to TB control organizatins.