2011-2015年合肥市新型结核病防治服务模式实施结果分析

Implementation results of the new service pattern for tuberculosis prevention and control in Hefei City,2011-2015

目的评价合肥市新型结核病防治服务模式实施情况,总结经验和分析不足,明确下一步工作重点。方法对合肥市2011-2015年结核病相关监测数据和结核病防治服务模式转型情况进行统计分析。结果结防服务模式转型中准备工作充分,2011-2015年随着结核病定点医院个数的增加,活动性肺结核患者检出率分别为29.36%、33.67%、42.67%、40.27%、39.27%,呈上升趋势(χ~2=642.12,P<0.01);新涂阳肺结核患者治愈率90%以上、涂阴肺结核患者完成疗程率94%以上和非结防机构网报疑似肺结核患者总体到位率93%以上均达到国家规划要求,且一直保持在较高水平;但初诊患者登记率、涂阳肺结核患者检出率、初诊患者免费摄片率和活动性肺结核患者免费抗结核药品使用率均呈下降趋势(P<0.01)。结论新型结核病防治服务模式下,结核病防治工作运行总体比较顺畅,但定点医院对痰检工作不够重视,且免费政策执行不到位。

Objective To evaluate the implementation of the new service pattern for tuberculosis （TB） prevention and control in Hefei City during 2011-2015, to summarize the experience and analyze the existing problems, and to identify the key points of the next work. Methods We statistically analyzed the TB-related monitoring data and the transformation of the service pattern for TB prevention and control in Hefei City during 2011-2015. Results The preparation of the transformation of the service pattern for TB prevention and control was good enough. Along with the increasing number of TB designated hospitals during 2011-2015, the annual detection rates of patients with active pulmonary tuberculosis were 29.36%, 33.67%, 42.67%, 40.27% and 39.27% respectively, showing a rising tendency （χ^2=642.12, P〈0.01）. The curative rate of the new smear positive patients （〉90%）, the treatment completion rate of smear negative patients （〉94%） and the overall arrival rate of the suspected patients tracing by non-TB institutions （〉93%） all conformed to the national program requirements, and also remained at a high level. However, the registration rate of the first-diagnosed patients, the detection rate of smear positive pulmonary tuberculosis patients, the free examination rate of X-raying in the first-diagnosed patients and the free using rate of anti-tuberculosis drugs in the active pulmonary TB patients tended to decline （P〈0.01）. Conclusions The work of TB prevention and control in the new service system runs well in general, but the designated hospitals underemphasize the sputum examination and the execution of the free policy is not good enough.