四川省非户籍人口结核病防治效果分析

A Study on the Effect of TB Management for Non-resident Population in Sichuan Province

目的了解和评价2010-2014年四川省非户籍人口肺结核病跨区域防治管理工作实施情况,探索制约四川省非户籍人口肺结核患者利用公共卫生服务的制度缺陷,为完善非户籍人口肺结核患者跨区域管理工作提出对策。方法采用定量分析的方法,通过结核病专报信息系统收集四川省21个市州地区非户籍人口和户籍人口肺结核患者资料进行统计分析。结果 2010-2014年四川省登记户籍人口活动性肺结核患者288 976例,登记非户籍人口活动性肺结核患者11 005例。非户籍患者来源主要以转诊(34.03%)、追踪(32.86%)为主;在四川省转出的140例非户籍患者中,未反馈率、到位率及代管率均高于转入的1 182例非户籍患者(P<0.05),转出的非户籍人口患者到位率低于户籍人口患者(P<0.05),转出患者在西部地区反馈平均时间最长,为108.31天;非户籍人口新涂阳肺结核患者治疗满一年后丢失率高于户籍人口新涂阳患者(P<0.05),非户籍人口新涂阳肺结核患者完成治疗率在5年间有提高趋势(P<0.05)。结论肺结核患者跨区域管理程序实施是保证非户籍人口肺结核患者持续治疗的有效措施,结核病专报信息系统的管理功能基本满足工作需要,各级结防机构特别是西部地区应尽力强化督导与协作,加强对非户籍人口患者健康宣传力度,确保该工作顺利开展。

Objective To study the effects of cross - regional management for non - resident population with TB in Sichuan from 2010 to 2014, to explore the deficiency that hindered the utilization of health services for non -resident population with TB in our province, and to propose suggestion on the cross -regional management of non - resident population of tuberculosis patients in our province. Methods Gather information of migrant population and host population TB cases from 21 cities of Sichuan province via TB report information system and analyze these data by quantitative method. Results 288 976 resident population and 11 005 non -resi- dent population active TB cases were diagnosed and registered in dispensaries in Sichuan from 2010 to 2014 respectively. Non -resident TB cases went to dispensaries mainly because of referral （34. 03% ）, trace （32. 86% ）. The non - feedback rate for arrival and the actual arrival rate of 140 non - resident population TB patients who were transferred out are higher than that of 1 182 non - resident TB patients who were trans-ferred in. The arrival rate of transferred- out non- resident TB patients was lower than that of transferred - out resident TB patients. The median time - delayed feedbacks have differed in 4 areas of China, which in- clude the east, the middle, the west of China and within Sichuan province. The west of China is the longest （21days）. The lost rate of newly smear positive non - resident TB patients who have been treated for one year was higher than that of newly smear positive resident TB patients, and the success treatment rate of the former ones have shown a steady growth over the past 5 years. Conclusion The cross - regional management procedure of pulmonary tuberculosis patients is the effective measure to guarantee the continuous treatment for non - resi- dent TB patients. The function of TB information management system could meet our needs basically. The staff who manages non - resident TB patients, especially work in the west of China, should by all means strengthen supervision and cooperation at all levels, intensify the health awareness and education of non - resi- dent population to make sure the success of this work.