昆明市四城区实施不同结核病管理模式的效果评价

Evaluation of implementation of different tuberculosis management modes in four districts of Kunming City

目的评价昆明市四城区实施定点医院结核病防治模式和实施疾控模式效果。方法收集结核病专报系统报表数据,以实施疾控模式的盘龙区、五华区作为对照,对2010年7月1日—2012年9月30日昆明四城区结核病专报数据分析。结果昆明市两城区实施定点医院模式后,病人发现方式主要为因症就诊(75%),病人登记数较项目实施前增加79.65%,同时涂阴病人诊断能力大幅度提高(49.1%vs24.5%),涂阴病人数明显增加,患者就诊延迟和诊断延迟情况得到改善。但涂阳病人治愈率和涂阴病人完成疗程率较实施前降低。结论昆明市定点医院在诊断和治疗水平上能承担和胜任结核病防治工作,但应加强病人随访管理工作。

Objective To evaluate the effect of different tuberculosis（TB）management modes（TB-control in designated hospitals or in disease control centers）in four districts of Kunming City. Methods The data of the TB reporting system were collected and analyzed in four districts of Kunming City from 2010.7.1 to 2012. 9.30. Results Compared with the data in Panlong and Wuhua districts where the management mode in the disease control centers was implemented （as controls）, after the implementation of the management mode in the designated hospitals in two districts, the main way of discovering the TB patients was symptomatic seeing a doctor（75% ）, the registration number of TB patients was more than that in previous years, increasing by 79.65%, while the smear-negative patients with diagnostic capabilities greatly improved （49.1% vs. 24.5% ） , smear-negative patients increased significantly, and the treatment delay situation and diagnosis delay situation significantly reduced. However, the cure rate of smear-positive patients and completed treatment rate of smear-negative patients both reduced compared with those in previous years. Conclusion In Kunming City, the designated hospitals with the capability of TB diagnosis and treatment can afford and be competent in the TB prevention and control work, but they should enhance the patient management.