河南省128家结核病防治机构卫生资源配置现状分析

Analysis on the status quo of health resource allocation of 128 tuberculosis control institutions in Henan Province

目的 了解河南省结核病防治（简称“结防”）机构卫生资源配置现状,为制定全省结核病防治规划提供科学依据.方法 2016年7月河南省疾病预防控制中心采用普查的方法对2015年全省128家结防机构进行现况调查;根据《中国结核病防治规划实施工作指南（2008年版）》设计了《河南省结核病防治机构服务能力调查表》,对全省结防机构卫生资源中的人力资源、防护设施,常用检查设备和肺结核患者的发现、治愈情况进行调查.结果 本次调查了全省128家结防机构,有4种结防模式,其中结防所14家、传染病医院6家、定点医院10家、疾病预防控制中心结防所98家.全省市、县结防机构应配备结防人员2268名,实配备2051名,配备率90.4％（2051/2268）.全省结防人员中专及以下学历693名,占33.8％（693/2051）;大专及以上学历1358名,占66.2％（1358/2051）.无执业资质人员792名,占38.6％（792/2051）,有执业资质人员1259名,占61.4％（1259/2051）.无职称人员430名,占21.0％（430/2051）,有职称人员1621名,占79.0％（1621/2051）.全省结核病门诊、痰检室、痰培养室工作用房584间,有338间安装了排风扇,安装率为57.9％（338/584）;有437间安装了洗手水管,安装率为74.8％（437/584）;有463间配备了N95口罩,配备率为79.3％（463/584）;有171间安装的紫外线灯达到规划要求,达标率为29.3％（171/584）.128家结防机构中共有11种常用检查设备1009台,配备率为71.7％（1009/1408）.2015年全省共发现活动性肺结核患者60 825例,当年末辖区人口为10 722万名,发现率为56.7/10万（60 825/107 220 000）;治疗管理2014年涂阳肺结核患者15 648例,治愈13 823例,治愈率为88.3％（13 823/15 648）.结论 河南省结防机构卫生资源配置不足,各种防治模式间的配置也不平衡,应采取多种综合性措施来优化结防机构卫生资源配置.

Objective To understand the status quo of health resources allocation of tuberculosis prevention and control institutions （referred to as ＆quot;TB agencies＆quot;） in Henan Province,and to provide scientific evidence for the development of tuberculosis control plan in the province.Methods The status quo of 128 TB agencies in the province by the end of 2015 was investigated with the census method in July 2016.According to the ＆quot;China Tuberculosis Prevention and Control Plan Implementation Guide （2008）＆quot;,＆quot;Henan Province TB prevention and control institutions service capacity questionnaire＆quot; was designed to investigate the province＆#39;s TB health resources in the human resources,protective facilities,commonly used inspection equipment and the discovery and cure of tuberculosis patients.Results The investigation of the province＆#39;s 128 TB agencies showed that there are four kinds of tuberculosis prevention mechanisms,including 14 dispensaries,6 infectious hospitals,10 designated hospitals and 98 CDC.The TB agencies of cities and counties in the province should be equipped with 2268 tuberculosis prevention employees,but only 2051 were employed,with the rate of 90.4% （2051/2268）.There were 693 tuberculosis prevention employees graduated from technical secondary school and the following qualifications,accounting for 33.8% （693/2051）;there were 1358 employees with college education and above,accounting for 66.2% （1358/2051）,792 personnel have no qualification,accounting for 38.6% （792/2051） and there were 1259 qualified personnel,accounting for 61.4 % （1259/2051）.There were 430 no-title staff members,accounting for 21.0 % （430/2051） and 1621 staff members with titles,accounting for 79.0% （1621/2051）.There were 584 work rooms including tuberculosis clinic,sputum smear room,and sputum culture room,338 of which installed fans,with the installation rate of 57.9% （338/584）;there were 437 rooms installed a hand-washing water pipe,with the installation rate of 74.8% （437/584）;there were 463 rooms equipped with N95 masks,with a rate of 79.3% （463/584）;there were 171 rooms installed UV lights that have achieved planning requirements,with a compliance rate of 29.3% （171/584）.In the 128 TB agencies,there were 1009 commonly used inspection equipments in a total of 11 categories,with a rate of 71.7% （1009/1408）.A total of 60 825 cases of active tuberculosis were found in the province in 2015.The population at the end of the year was 107.22 million,the rate was 56.7 per million （60 825/107 220 000）,15 648 cases of smear-positive pulmonary tuberculosis in 2014 were treated and 13 823 cases were cured,with a cure rate of 88.3% （13 823/15 648）.Conclusion The health resources allocation is not enough for the TB agencies in Henan province and the configuration of different TB agencies is not balanced.A variety of comprehensive measures should be taken to optimize the TB health resources allocation.