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中国防痨杂志 ›› 2018, Vol. 40 ›› Issue (7): 768-771.doi: 10.3969/j.issn.1000-6621.2018.07.018

• 论著 • 上一篇    下一篇

北京市密云区结核病健康管理纳入公共卫生服务项目实施前后效果分析

唐晓丽(),郭玉凤,蔡华立   

  1. 101500 北京市密云区结核病防治所
  • 收稿日期:2018-04-16 出版日期:2018-07-10 发布日期:2018-09-07
  • 通信作者: 唐晓丽 E-mail:tangxiaolisw@163.com

Effect analysis of the health management of tuberculosis incorporated into the public health service project in Miyun District, Beijing

Xiao-li TANG(),Yu-feng GUO,Hua-li. CAI   

  1. Miyun Tuberculosis Control Institute of Beijing, Beijing 101500, China
  • Received:2018-04-16 Online:2018-07-10 Published:2018-09-07
  • Contact: Xiao-li TANG E-mail:tangxiaolisw@163.com

摘要:

目的 分析和评价密云区结核病患者健康管理纳入基本公共卫生服务项目(简称“公卫项目”)对结核病预防控制工作的成效。方法 对密云区结核病患者健康管理纳入公卫项目前2年(2014年1月至2015年12月)与纳入公卫项目后2年(2016年1月至2017年12月)的患者的发现、转诊及治疗转归情况进行比较分析,探讨结核病患者健康管理纳入到公卫项目的实施效果。应用SPSS 18.0软件进行统计学分析,率的比较采用χ 2检验,以P<0.05为差异有统计学意义。 结果 活动性肺结核患者发病率由2014—2015年的41.63/10 万(404/970000)下降到2016—2017年的35.00/10万(336/960000),下降了6.63/10万。涂阳患者发现率由2014—2015年的29.70%(120/404)上升至2016—2017年的33.93%(114/336),提高了4.22个百分点,但差异无统计学意义(χ 2=1.515,P=0.218)。未查痰患者比率由2014—2015年的19.31%(78/404)下降至2016—2017年12.50%(42/336),下降了6.81个百分点,差异有统计学意义(χ 2=6.266,P=0.012)。转诊到位率由2014—2015年的67.81%(455/671)上升至2016—2017年的74.50%(482/647),上升了6.69个百分点,差异有统计学意义(χ 2=7.170,P=0.007)。总体到位率由2014—2015年的93.29%(626/671)上升至2016—2017年的96.75%(626/647),上升了3.46个百分点,差异有统计学意义(χ 2=8.293,P=0.004)。新涂阳患者治愈率由2014—2015年的87.78%(79/90)上升至2016—2017年的95.71%(134/140),上升了7.93个百分点,差异有统计学意义(χ 2=5.041,P=0.025)。结论 结核病患者健康管理纳入到公卫项目后,未查痰患者比率下降,患者转诊到位率、新涂阳患者治愈率等有所提高,对结核病疫情预防控制起到了促进作用。

关键词: 结核, 肺, 疾病管理, 公共卫生工作, 小地区分析, 对比研究

Abstract:

Objective To analyze and evaluate the effect of tuberculosis (TB) prevention and control work, after taking the health management of TB patients into the basic public health service project in Miyun district (hereinafter referred to as the “public health project”).Methods Through comparatively analyzing the situation the patients’ discovery, referral, and treatment outcome between the years from Jan.2014 to Dec.2015 and the last two years since Jan.2016 initiating public health project, to explore the implementation effects of taking TB health mana-gement into public health project. SPSS 18.0 software was used for statistical analysis and chi-square test was used to compare the rates. P<0.05 was considered the difference had statistical significanceResults The incidence of patients with active TB fell by 6.63/100000, from 41.63/100000 (404/970000) (2014-2015) to 35.00/100000 (336/960000) (2016-2017). The discovery rate of smear-positive patient increased by 4.22%, from 29.70% (120/404) (2014-2015) to 33.93% (114/336) (2016-2017), and the difference had no statistical significance (χ 2=1.515, P=0.218). The proportion of patients did not test sputum decreased by 6.81%, from 19.31% (78/404) (2014-2015) to 12.50% (42/336) (2016-2017), and the difference had statistical significance (χ 2=6.266, P=0.012). The rate of referral arrival increased by 6.69%, from 67.81% (455/6710 (2014-2015) to 74.50% (482/647) (2016-2017), and the difference had statistical significance (χ 2=7.170, P=0.007).The overall arrival rate increased by 3.46%, from 93.29% (626/671) (2014-2015) to 96.75% (626/647) (2016-2017), and the difference had statistical significance (χ 2=8.293, P=0.004). The cure rate of new smear positive cases increased by 7.93%, from 87.78% (79/90) (2014-2015) to 95.71% (134/140) (2016-2017), and the difference had statistical significance (χ 2=5.041, P=0.025).Conclusion The proportion of patients did not test sputum decreases, and the rate of referral arrival and cure rate of new smear positive cases increase. In short, taking TB patients health management into the basic public health project improves the TB prevention and control.

Key words: Tuberculosis, pulmonary, Disease management, Public health practice, Small-area analysis, Comparative study