南宁市医疗卫生机构AIDS转介服务的开展现状及转介到位的影响因素

Current situation of referral services for AIDS patients and influencing factors of referral arrival in medical and health institutions in Nanning City

目的了解南宁市医疗卫生机构AIDS转介服务的开展现状,并分析转介到位的影响因素。方法按照不同级别和性质,选取20个医疗卫生机构,HIV筛查检测数以及2018年1~6月艾滋病病例报告数均较多。对比不同级别和性质医疗卫生机构的转介率、转介到位率,分析转介到位的影响因素。调查患者未获得转介服务及转介未到位的原因。结果20家医疗卫生机构共报告279例HIV感染者/AIDS患者,其中提供转介服务244例(87.5%),转介到位166例(68.0%)。省级医疗卫生机构的转介率、转介到位率均高于县(区)级,疾控中心的转介率、转介到位率均高于综合医院(均P<0.05)。未获得转介服务的原因主要是“医生忘记”“患者当场拒绝转介服务”,转介未到位的原因主要是“追踪失联”“中途放弃”“不在本地”。多因素分析结果显示,年龄、文化程度、职业、转介机构级别、转介机构性质是HIV感染者/AIDS患者转介到位的影响因素(均P<0.05)。结论南宁市开展的AIDS转介服务取得了一定的成效,但转介到位率仍较低,且受多种因素影响。

Objective To investigate the current situation of referral services for AIDS patients,and to analyze the influencing factor of referral arrival in medical and health institutions in Nanning City. Methods According to different levels and natures,20 medical and health institutions were selected,which had greater number of HIV screening testing and more AIDS cases reported during January and June 2018.Referral rate and referral arrival rate were compared among medical and health institutions of different levels and characteristics,and the influencing factors of referral arrival were analyzed.A survey was conducted on the reasons why patients did not get referral services and the reasons for no achieving referral arrival. Results A total of 279 HIV-infected/AIDS patients were reported in the 20 medical and health institutions,of which 244(87.5%) received referral services provided and 166(68.0%) achieved referral arrival.Provincial medical and health institutions had higher referral rate and referral arrival rate than the institutions of county(district) level,and the referral rate and referral arrival rate of center for disease control and prevention were higher than those of general hospital(all P <0.05).The main reasons for not getting referral services were "doctors forget providing referral services" and "patients refuse referral services on the spot".The main reasons for not achieving referral arrival were "being lost to follow up","giving up halfway" and "absence in local".Multivariate analysis results showed that age,educational level,occupation,referral institution level,and referral institution nature were influencing factors of referral arrival in HIV-infected/AIDS patients(all P <0.05). Conclusion AIDS referral services make a certain achievement in Nanning City,however,the referral arrival rate is still low and affected by various factors.