深圳市820例重点性病规范化治疗影响因素

Risk factors influencing standardized treatment of 820 patients with STD in Shenzhen

目的探讨深圳市重点性病规范化治疗影响因素,为进一步加强医疗机构管理和提高重点性病诊疗质量提供科学依据。方法采取随机抽样的原则,在中国疾病预防控制信息系统中抽取重点性病患者820例为研究对象,对患者就诊和治疗一般资料进行描述性分析,对变量进行多因素回归分析。结果 820例性病患者中规范治疗率68.17%(559/820),不规范用药、不足疗程或无治疗率31.83%(261/820)。三种重点性病中梅毒规范治疗率65.90%(257/390),淋病66.35%(140/211),衣原体73.97%(162/219)。不同医疗机构中,综合民营医院性病规范治疗率64.31%(164/255),综合公立医院66.41%(172/259),专科医院51.37%(75/146),防治机构92.50%(148/160)。医院不同接诊科室中皮肤科规范治疗率71.20%(262/368),妇产科65.24%(137/210),泌尿科69.87%(109/156),其他科室59.30%(51/86)。重点性病规范治疗与医院性质有关,专科医院相对较差(OR=17.918),其次为综合民营医院(OR=8.310),再次为综合公立医院(OR=6.745)。三种重点性病中,与衣原体比较,梅毒不规范治疗率34.10%(OR=1.556),淋病不规范治疗率33.65%(OR=1.758)。结论要加强医疗机构管理和全员培训,落实奖惩措施,提高性病诊疗质量。

Objective To explore the influencing factors of standardized treatment of sexually transmitted disease（STD）in Shenzhen City,so as to provide the evidence for improving the management of medical institutions and quality of STD.Methods A total of 820 patients with STD（syphilis,gonorrhea,and chlamydia） were randomly enrolled as research subjectsand their data were collected from the China information system for disease control and prevention. The general information ofthe patients was descriptively analyzed,and the variables were analyzed with the multivariate regression analysis method.Results The standardized treatment rate of patients with STD was 68.17%（559/820）,and the irregular treatment rate was31.83%（261/820）. Among 3 types of key STD,the standardized treatment rates of syphilis,gonorrhea and chlamydia were65.90%（257/390）,66.35%（140/211） and 73.97%（162/219） respectively. However,the standardized treatment rates variedwith different medical providers,and the standardized treatment rates were 64.31%（164/255）,66.41%（172/259）,51.37%（75/146）,and 92.50%（148/160） in the comprehensive private hospitals,comprehensive public hospitals,specialist hospitals,andpublic health institutions respectively. Among different departments of hospitals,the standardized treatment rates were 71.20%（262/368）,65.24%（137/210）,69.87%（109/156）,and 59.30%（51/86） in the department of dermatology,department of obstetricsand gynecology,department of urology,and other departments.Focused on STD treatment and hospital properties,thestandardization of treatment in specialist hospital was relatively poor（OR=17.918）,followed by comprehensive private hospitals（OR=8.310）,and then comprehensive public hospitals（OR=6.745）. Compared with chlamydia,the non-standardized treatmentrate of syphilis was 34.10%（OR=1.556）,and non- standardized treatment rate of gonorrhea was 33.65%（OR=1.758）.Conclusion It is essential for medical institutions to strengthen the management,training of health care workers andimplementation of reward and punishment measures,in order to improve the quality of STD standardized treatment.