流动人口肺结核患者跨区域管理转入地违规重新登记影响因素分析

Analysis on influencing factors of violation of re-registration of the receiving institution in trans-regional management for tuberculosis control of floating population

目的初步探讨转入地结核病防治机构违规重新登记原因,为今后流动人口管理工作的顺利开展和相关政策的制定提供科学依据。方法将南山区2007年10月至2009年9月转入其他地区且2个月内到位治疗的流动人口肺结核患者作为研究对象,收集患者的一般情况、患病情况和跨区域管理相关资料,分别用单变量、多变量统计方法分析转入地违规重新登记的可能影响因素。结果多变量统计显示,第一项目年转出患者和痰涂片阳性患者被转入地违规重新登记率较高,差异有统计学意义(P<0.05);第二项目年我区转出患者主动告知率为67.5%,到位率为60.8%,转入地结防机构信息反馈率为95.8%,代管率为41.1%,较第一项目年各项指标均有大幅提高。结论跨区域管理工作随着开展的深入已初现成效,但由于为完成当地涂阳病人发现和登记治疗管理任务等原因,转入地结防机构违规重新登记现象仍较为严重,政府需对此加强规范管理力度。

Objective To preliminarily study the reasons of violation of re-registration by the receiving tuberculosis control institution,and to provide scientific basis for the successful development of the management and the related policy making for the floating people.Methods The study included all the non-resident TB patients who were registered by Shenzhen Nanshan Chronic Disease Center and transferred into other district during 1st October,2007 to 30th September,2009 as the subjects.Data on their basic conditions,sickness status and trans-regional management were collected to analyze the possible influencing factors of the management mode of the receiving institution.Results Smear-positive cases and the first year of the program had significantly higher re-registration rate（P〈0.05）.In the second year of the problem,the informing rate and the arrival rate of the patients were respectively 67.5% and 60.8%,and the information feedback rate and adopting subsequent therapy rate of the receiving institution were respectively 95.8% and 41.1%.All the 4 indicators rose remarkably in the second year of the problem in nanshan district.Conclusion The trans-regional management had made a initial progress as it went further,but in order to complete the task of the registration and management of the smear-positive cases,violation of re-registration by the receiving institution was still a severe problem,which needed the government to put more efforts into regulation.