《手机一体化管理系统》在学校结核病防控中的应用效果评价

Evaluation of effectiveness of applying Mobile integrated management system in school TB prevention and control

目的 评价结核病防治《手机一体化管理系统》(简称《一体化系统》)在学校结核病防控中的应用效果,为今后《一体化系统》的升级和改造提供科学依据.方法 收集2018-2019年《惠州市结核病患者登记本》《结核病专报系统》及《一体化系统》的数据.调查1462所学校,使用《一体化系统》前(2018年)和使用《一体化系统》后(2019年)分别发现220、198例疑似学生肺结核患者,分别有114、116例学生肺结核患者确诊.分析使用《一体化系统》前和使用《一体化系统》后各自的防控效果,并且进行对比分析.实施《一体化系统》前后各种“率”的比较采用x2检验,以P<0.05为差异有统计学意义.结果 使用《一体化系统》前学校疑似肺结核患者转诊信息准确率为83.2%(183/220),低于使用《一体化系统》后的97.0%(192/198)(x2=21.446,P<0.01);使用《一体化系统》前学校疑似肺结核患者转诊信息1h到达率为58.2%(128/220),低于使用《一体化系统》后的98.0% (194/198)(x2=93.295,P<0.01);使用《一体化系统》前疑似肺结核患者追踪执行率为70.9%(156/220),低于使用《一体化系统》后的97.0%(192/198)(x2=50.764,P<0.01);使用《一体化系统》前学校肺结核患者管理通知单推送准确率为86.0%(98/114),低于使用《一体化系统》后的99.1%(115/116)(x2=14.576,P<0.01);使用《一体化系统》前肺结核患者管理通知单1h到达率为57.0%(65/114),低于使用《一体化系统》后的98.3%(114/116)(x2=56.714,P<0.01);使用《一体化系统》前休(复)学通知书1h到达率为57.9%(66/114),低于使用《一体化系统》后的99.1%(115/116)(x2=58.334,P<0.01);使用《一体化系统》前核实学籍身份的学校覆盖率为86.0%(1257/1462),低于使用《一体化系统》后的99.0%(1447/1462)(x2=177.442,P<0.01).结论 《一体化系统》使用后较使用前在校园疑似患者转诊追踪、学生肺结核患者治疗管理、休(复)学管理,以及核实学籍身份覆盖方面均得到了改善,效果明显.

Objective To evaluate effectiveness of using Mobile integrated management system(referred to as"integrated system")in school tuberculosis prevention and control,so as to provide scientific evidence for upgrading the integrated system in the future.Methods Data from TB patient registration book,national TB information management system and integrated system in Huizhou City from 2018 to 2019 were extracted,1462 schools were investigated.Before the integrated system were used(2018),220 suspected cases of TB and 114 confirmed cases of TB were found,while after using the system(2019),198 suspected cases and 116 confirmed cases were detected.Thus,we analyzed effectiveness of the system b y conducting before and after study.χ~2 test was used to compare various"rates"before and after the implementation of the integrated system,with a statistical significance of 0.05.Results The accuracy rate of information for referring suspected tuberculosis patients in schools before using the integrated system was 83.2%(183/220),lower than 97.0%(192/198)after using the integrated system(χ~2=21.446,P<0.01);the rate of prompt information exchange(within 1 hour)before using the integrated system was58.2%(128/220),which was lower than 98.0%(194/198)after using the integrated system(χ~2=93.295,P<0.01);the tracking rate of suspected TB patients before using the integrated system was 70.9%(156/220),which was lower than 97.0%(192/198)after using the integrated system(χ~2=50.764,P<0.01);Before using the integrated system,the accuracy rate of school TB management notice which were pushed from CDC to school was86.0%(98/114),lower than 99.1%(115/116)after using the integrated system(χ~2=14.576,P<0.01);the rate of prompt information exchange(within 1 hour)for those management notice before using the integrated system was 57.0%(65/114),lower than 98.3%(114/116)after using the integrated system(χ~2=56.714,P<0.01);the rate of prompt information exchange(within 1 hour)for notice of suspension(resuming)of schooling before using the integrated system was 57.9%(66/114),lower than 99.1%(115/116)after using the integrated system(χ~2=58.334,P<0.01);the school coverage rate of verifying the student status before using the integrated system was 86.0%(1257/1462),which was lower than 99.0%(1447/1462)after using the integrated system(χ~2=177.442,P<0.01).Conclusion After using the integrated system,the performance of referral and tracking of suspected patients in campus,treatment management of students with pulmonary tuberculosis,management of suspension(resuming)of schooling,and coverage of schools which could verify student status and identity are better than before.The effect is obvious.