浙江省常山县“移动结核门诊”服务在结核病防控中的实施效果评价

Evaluation of the implementation effect of “mobile tuberculosis clinic”service in the prevention and control of tuberculosis in Changshan County,Zhejiang Province

通过描述性研究,对比分析"移动结核门诊"服务前4年(2013—2016年)(简称"实施前")和后3年(2017—2019年)(简称"实施后")常山县患者发现和治疗管理等指标。实施前后计数资料的比较采用χ^(2)检验,以P<0.05为差异有统计学意义。结果显示实施后共服务患者146例、263例次。结核病患者登记发病率由实施前的118.31/10万(1144/966 944)下降至实施后的99.25/10万(746/751 611),差异有统计学意义(χ^(2)=13.54,P=0.000);病原学阳性患者治愈率由实施前的87.47%(363/415)上升到实施后的94.12%(336/357),差异有统计学意义(χ^(2)=9.91,P=0.002);病原学阴性患者完成疗程率由实施前的88.89%(648/729)上升到实施后的93.83%(365/389),差异有统计学意义(χ^(2)=7.28,P=0.007);曾经中断治疗结核病患者的治疗成功率由实施前的52.14%(122/234)上升到实施后的93.15%(136/146),差异有统计学意义(χ^(2)=69.38,P=0.000)。结论 "移动结核门诊"服务实施后提高了常山县结核病患者管理的质量,为进一步改善结核病防治管理模式提供了依据和参考。

In this study,a descriptive study was used to compare the data of patient detection and treatment management in Changshan County in the four years before(2013-2016)(referred to as"before implementation")and the three years after(2017-2019)(referred to as "after implementation")the implementation of "mobile tuberculosis clinic"service.Chi-square test was used for count data comparison before and after implementation,with P<0.05 for the difference was statistically significant.The results showed that 146 patients and 263 times were served after the implementation.The registration rate of tuberculosis patients was decreased from 118.31/100 000(1144/966 944)to 99.25/100 000(746/751 611),and the difference was statistically significant(χ^(2)=13.54,P=0.000).The cure rate of pathogenic positive patients increased from 87.47%(363/415)to 94.12%(336/357),with statistically significant difference(χ^(2)=9.91,P=0.002).The completion rate of treatment for patients with negative etiology increased from 88.89%(648/729)to 93.83%(365/389),with a statistically significant difference(χ^(2)=7.28,P=0.007).The treatment success rate of tuberculosis patients who interrupted treatment increased from 52.14%(122/234)to 93.15%(136/146),with statistically significant difference(χ^(2)=69.38,P=0.000). Conclusion After the implementation of"mobile tuberculosis clinic"service,the quality of tuberculosis patient management in Changshan County has been improved,which provides the basis and reference for further improving the management mode of tuberculosis prevention and treatment.