湖北省流动人口肺结核患者跨区域管理及治疗效果分析

Analysis of the cross-regional management and treatment effect of tuberculosis patients in floating population of Hubei Province

目的了解湖北省流动人口肺结核患者跨区域治疗和管理情况，为进一步规范流动人口肺结核患者管理提供参考依据。方法采用《结核病管理信息系统》病案管理模块中的患者转入转出管理内容，收集2010-2014年湖北省跨区域流动的肺结核患者的病案信息，共纳入1536例患者作为研究对象，包括转出患者482例，转入患者1054例。对转出和转入患者的基本特征、区域分布、到位情况、管理方式和治疗转归等进行分析。结果跨区域流动肺结核患者以男性为主，占66．21％（1017／1536），省内流动的比例为22．66％（348／1536），跨省流动的比例为77．34％（1188／1536）。跨区域流动肺结核患者的信息反馈率、总到位率、到位代管率和到位重新登记率分别为100．00％（1536／1536）、77．21％（1186／1536）、81．62％（968／1186）、15．51％（184／1186）。转出患者到位率（85．48Yoo，412／482）高于转入患者（73．43％，774／1054），差异有统计学意义（X2=27．26，P〈O．01）；转出患者到位代管率（86．17％，355／412）高于转入患者（79．20％，613／774），差异有统计学意义（X2=8．70，P=0．003）；转出患者到位重新登记率（9．47％，39／412）低于转入患者（18．73％，145／774），差异有统计学意义（X2=17．62，P〈O．01）。未到位患者主要原因为：未回（31．71％，111／350）、查无此人（13．14％，46／350）、地址有误（10．29％，36／350）。跨区域流动肺结核患者的治疗成功率为68．10%（1046／1536），转出到位患者治疗成功率（81．55％，336／412）高于转入到位患者（73．26％，567／774），差异有统计学意义（X2=10．19，P=0．001）；转出和转入到位代管患者成功治疗率分别为88．73％（315／355）、87．11％（534／613），差异无统计学意义（X2=0．55，P=0．460）。结论湖北省流动人口肺结核患者跨区域管理模式取得一定成效，到位代管患者治疗成功率较高，但应进一步提高患者到位率和到位代管率。

Objective To analyze the cross-regional treatment and management of the tuberculosis （TB） patients in floating population of Hubei Province, and thus to provide reference for further standardization of the management of TB patients in floating population. Methods By using the record management module in TB information management system, record information for TB patients in floating population from 2010 to 2014 were collected. A total of 1536 TB patients were taken as study subjects, including 482 transfer-out patients and 1054 transfer-in patients. We analyzed the basic characteristics, regional distribution, arrival in place situation, patient management and treatment outcome for both transfer-in and transfer-out patients. Results The majority of cross- regional TB patients were male, which constitute 66.21% （1017/1536） of all patients. The proportions of cross- regional TB patients were 22. 660/oo （348/1536） for inner-provincial flow and 77. 34% （1188/1536） for inter-provin- cial flow. The information feedback rate, total arrival in place rate, taking over rate and re-registration rate for cross-regional TB patients were 100. 00% （1536/1536）, 77.21% （1186/1536）, 81.62% （968/1186） and 15.51% （184/1186） respectively. The arrival in place rate and the taking over rate of the transfer-out patients were 85.48% （412/482） and 86.17% （355/412） respectively, which were significantly higher than the transfer-in patients （73. 43% （774/1054） and 79. 20% （613/774）） （X^22=27. 26, P〈0. 01; X^2=8.70, P=0. 003）. The re-registration rate of the transfer-out patients was 9.47% （39/412）, which was significantly lowered than the transfer-in patients （18.73%, 145/774） （X2=17.62, P〈0.01）. The main reasons for the non-arrival in place were no return （31.71%,111/350）, no such person （13.14%, 46/350） and wrong address （10.29%, 36/350）. The total treat ment success rate for cross regional TB patients was 68.10% （1046/1536）. The total treatment success rate for arrival in place transfer-out patients was 81.55% （336/412）, which was significantly higher than the arrival in place transfe^in patients （73.26%, 567/774） （X2=10.19, P= 0. 001）. The treatment success rates for taking over pa- tients were 88.73% （315/355） and 87.11% （534/613） for transfer-out and transfer-in patients respectively. The difference was not statistically significant （X^2=0.55, P=0. 460）. Conclusion The management of cross regional TB patients in floating population of Hubei province has achieved a certain effect. The treatment success rate was relatively high for taking over patients. However, measures should still be taken to further improve the arrival in place rate and the taking over rate.