关键词: 结核, 肺, 卫生服务需求, 卫生服务使用研究, 上海市

Abstract: Objective  To analyze the needs and utilization of health service in patients with pulmonary tuberculosis in Minhang district of Shanghai city, and evaluate the factors influencing the utilization of health service.  Methods  In 2010, a total of 1 286 830 copies of electronic health records were established in Minhang district, of which 749 were records specially for registered pulmonary tuberculosis. These 749 pulmonary tuberculosis cases and 502 patients among them which have been cured were taken as research subjects to analyze their epidemiological and management information, the needs and utilization of health service for tuberculosis patients. Univariate and multivariate logistic regression analysis was made to analyze the factors affecting their health service utilization. Results  Among the filing population in Minhang district in 2010, the prevalence of pulmonary tuberculosis was 58.21/100 000, the prevalence of active pulmonary TB (sputum positive) was 30.62/100 000, and the prevalence of chronic diseases was 51.54%（386/749）. Among the 502 cases who have been cured or have completed the full-course treatment, the frequency of clinic visits, laboratory examinations, and DOT supervisions in terms of times were 2.74, 9.02 and 5.47 times respectively. Patients older than 65 years (β=－2.513, Wald χ²=0.508, P=0.000, OR(95.0%CI)=0.081(0.030~0.219)), with pulmonary tuberculosis and other chronic diseases(β=－3.987, Wald χ²=0.458, P=0.000, OR(95.0% CI)=0.136(0.047~0.491)) are more likely to increase the frequency of clinic visits. Conclusion  The patients with pulmonary tuberculosis in Minhang district have a high requirement for health services, however, the utilization is adversely low. We should carry out targeted prevention measures for different groups of people, grasp their needs of health service, and improve their health services utilization.

Key words: Tuberculosis,pulmonary, Health services needs and demand, Marketing of health services, Shanghai city