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中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (9): 539-543.

• 论著 • 上一篇    下一篇

非结核病防治机构网络报告肺结核患者转诊不到位影响因素分析

李新旭 杨天池 姜世闻 贺晓新 周琳 李杨 吴卫东 刘小秋 张慧 王黎霞   

  1. 中国疾病预防控制中心结核病预防控制中心（李新旭、姜世闻、刘小秋、张慧、王黎霞）；浙江省宁波市疾病预防控制中心传染病防治所（杨天池）；北京市结核病控制研究所（贺晓新）；广东省结核病防治研究所（周琳）；贵州省疾病预防控制中心结核病防治研究所（李杨）；新疆维吾尔族自治区疾病预防控制中心结核病防治中心（吴卫东）
  • 收稿日期:2011-06-20 出版日期:2011-09-10 发布日期:2012-01-29
  • 通信作者: 刘小秋 E-mail:leon@chinatb.org

Factors impacting on not arriving at TB dispensaries of TB cases reported and referred by non-TB control institutions

LI Xin-xu, YANG Tian-chi, JIANG Shi-wen, HE Xiao-xin, ZHOU Lin, LI Yang, WU Wei-dong, LIU Xiao-qiu, ZHANG Hui, WANG Li-xia   

  1. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention
  • Received:2011-06-20 Online:2011-09-10 Published:2012-01-29

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摘要： 目的 了解非结核病防治机构（简称“非结防机构”）网络报告肺结核患者转诊不到位的影响因素，为制定强化医防合作的政策和措施提供参考依据。 方法 于2010年5—7月在北京、广东、贵州和新疆共选取8个县区招募235例转诊到位和226例转诊不到位患者，采用问卷调查的方式进行成组设计病例对照研究。 结果 多因素logistic回归模型分析结果显示：女性患者（OR=1.63；95%CI：1.06～2.51）、患者在就诊地居住<1年（OR=3.05；95%CI：1.36～6.86）、患者在就诊期间自付费用超过家庭人均年收入的60%（OR=1.94；95%CI：1.25～3.02）、转诊医生未向患者开具转诊单（OR=2.61；95%CI：1.69～4.04）、患者怀疑或不清楚结防机构提供的免费抗结核药物的治疗效果（OR=2.00；95%CI：1.29～3.11）、患者不知道结核病防治机构的位置（OR=3.04；95%CI：1.64～5.63）和患者转诊所需的时间>80 min（OR=2.71；95%CI：1.63～4.51）是转诊不到位的危险因素。 结论 为提高转诊到位率，非结防机构要多关注女性和流动人口患者，切实减轻患者疾病经济负担并规范转诊程序，结核病防治机构要加大健康促进工作力度并提供便民服务措施。

关键词: 结核, 肺, 病人转诊, 计算机通信网络

Abstract: Objective To identify the factors impacting on not arriving at TB dispensaries (TD) of TB cases (cases) reported and referred by non-TB control institutions (NTI), and provide the reference for developing policies to strengthen PPM.  Methods During May to July 2010, total 8 counties were sampled in Beijing, Guangdong, Guizhou and Xinjiang, and 235 cases who arrived at TD and 226 cases who didn’t arrive at TD were recruited to receive questionnaire interviews as control and case groups, respectively.  Results Multiple logistic regressions demonstrated that cases being female (OR=1.63; 95%CI:1.06-2.51), cases living less than one year in the place they were notified (OR=3.05; 95%CI:1.36-6.86), cases’ total expense from their pockets during in NTI exceeding their families’ annual income per capita by 60% (OR=1.94; 95%CI:1.25-3.02), physician in NTI not issuing referral sheets to cases (OR=2.61; 95%CI:1.69-4.04), cases suspecting or not knowing curative effect of TB drugs provided by TD (OR=2.00; 95%CI:1.29-3.11), cases not knowing the place of TD (OR=3.04; 95%CI:1.64-5.63) and cases needing more than eighty minutes from NTI to TD (OR=2.71; 95%CI:1.63-4.51) were significantly associated with cases not arriving at TD.  Conclusion In order to improve the arrival rate of referral, NTI should pay more attention to cases in female and floating population, and reduce cases’ economic burden, and TD should enhance health promotion, and provide convenient service measures.

Key words: Tuberculosis,pulmonary, Patient transfer, Computer communication networks

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