云南省六所医院艾滋病患者和慢性乙型丙型肝炎患者门诊就诊时间研究

Comparison of doctor′s consultation time with AIDS patients and patients with chronic hepatitis B and C from six hospitals of Yunnan

目的了解云南省不同治疗机构艾滋病（AIDS）患者和慢性乙型、丙型肝炎患者（简称慢性肝炎患者）的门诊就诊时间长短差别，并进一步探讨影响复诊的AIDS患者门诊就诊时间的因素。方法采用典型调查的方法，对2012年4--8月份到云南省六家治疗机构进行门诊治疗的AIDS患者进行问卷调查、统计就诊时间，并选取到同一家医疗机构进行门诊治疗的慢性肝炎患者作为对照。全部数据使用软件SAS9．2进行处理，构成比的比较采用Fisher确切概率法，两组时间中位数的比较采用WilcoxonTwo—SampleTest，多组时间中位数的比较采用KruskabWallisTest，多因素分析采用GeneralLinearModels。检验水准a=0．05。结果本研究共计调查门诊就诊的AIDS患者和慢性肝炎患者625人。初次转介的AIDS门诊患者和首次开始治疗的AIDS门诊患者就诊时间中位数为33．2min和32．8min，初诊的慢性肝炎门诊患者就诊时间中位数9．6min，差异有统计学意义（WilcoxonTwo—SamPleTestZ=4．7304，P〈0．01；Z=5．4891，P〈0．01）；复诊的AIDs门诊患者就诊时间中位数为10．6min，复诊的慢性肝炎门诊患者就诊时间中位数为6．6min，差异有统计学意义（WilcoxonTwo—SamPleTestZ=11．4950，P〈0．01）。影响复诊的AIDS门诊患者就诊时间长短的因素主要有患者年龄、治疗方案以及是否出现药物不良反应，儿童患者、使用二线方案的患者以及出现药物不良反应的患者的就诊时间更长。结论作为两种相似的慢性传染病，无论是初诊复诊，AIDS患者的门诊就诊时间都要长于慢性肝炎患者，说明负责治疗艾滋病的医务工作者在接待患者的过程中投入了更多的时间和精力。

Objective To compare doctorrs consultation time with AIDS patients and patients with chronic hep- atitis t3 and C from six hospitals of Yunnan province, and to further explore factors influencing the consulta- tion time with re-visiting AIDS outpatients. Methods A questionnaire survey was conducted on all AIDS outpatients in six hospitals of Yunnan province from April to August in 2012. The doctorrs consultation time was recorded and analyzed. Meanwhile, patients with chronic hepatitis B and C from the same hospital were al so surveyed as control. SAS 9.2 was used to process data. Wilcoxon Two-Sample Test, Kruskal-Wallis Test and General Linear Models were used for data statistical analysis. Results A total of 625 outpatients with AIDS and chronic hepatitis B and C were surveyed. The median value of consultation time for initial referral AIDS outpatients and patients who started their initial treatment were 33.2 and 32.8 minutes, which were both longer than the median value （9.6 min ） of initial visit patients with chronic hepatitis B and C （Wilcoxon Two-SamPle Test Z=4. 7304, P〈0. 0001; Z= 5. 4891, P〈0. 0001）. Meanwhile, the median value of con- sultation time for re-visiting AIDS outpatients was 10. 6 rain, which was also much longer than 6.6 min median value of revisiting patients with chronic hepatitis B and C （Wilcoxon Two-SamPle Test Z=11. 4950, P〈0. 0001） . Factors influencing the consultation time of re-visiting AIDS outpatients includeded age, therapeutic regimen and medicine side-effect. Conclusions The dotor＇s consultation time with both first time visit and re-visiting AIDS patients are longer when compared to patients with chronic hepatitis t3 and C, indicating that doctors are more responsible for AIDS patients.