网络直报肺结核病人追踪不到位原因分析

目的 了解医疗机构网络直报后未到结核病防治机构就诊的肺结核病人和可疑病人经追踪不到位的原因及影响因素，为提高追踪到位率提出建议。方法 由专业人员对2005年1～7月份网络直报而未到结防机构的肺结核病人和可疑者进行追踪，在追踪过程中对追踪不到位的原因进行调查了解，填写调查表，采用SPSS12．0软件对数据进行处理。结果 对资料完整的追踪不到位1278例病例进行分析，主要原因分别为长期外出168例（13．2％），拒绝返回164例（12.8％），经济困难161人（12．6％），查无此人128例（10．0％），住院118例（9．2％），交通不便114例（8．9％），工作忙碌8l例（6．3％）。结论 病人追踪不到位的主要原因以长期外出，拒绝返回，经济困难，查无此人，住院，交通不便以及工作忙碌居多，因此建议应进一步加强结核病健康促进宣传力度，增加病人对家庭和社会的责任感，增强就医观念。实施卫生行政干预，规范报告程序，填全填准所有的报告项目。政府对经济困难的病人提供就诊和治疗所需要的交通和食宿等相关的费用。对于住院病人应做好详细的登记，以便病人出院后及时将病人转到居住地结核病防治机构继续接受治疗，确保治愈。加强乡镇级卫生院结核病诊治能力的建设，方便病人就医。

Analysis on the Failures in Tracing the TB Patients by the Internet- based Reporting System

Objective To investigate the reasons and the mainly influencing factors of the reported TB patients and suspects by the internet-based reporting system who failed to come to the TB dispensary by tracing and make successful tracing recommendation.Methods The TB patients and suspects reported by the internet-based reporting system who failed to come to the TB dispensary between Jan.-July 2005 have been followed up by TB staffs,township and village doctors.Survey of the tracing failure reasons was conducted by the questionnaire.All the data was processed by SPSS12.0.Results 1 278 cases were analyzed.Outgoing 168(13.2%),refusing return 164(12.8%),financial problem 161(12.6%),cases not found 128(10.0%),hospitalization 118(9.2%),transportation inconvenient 114(8.9%),busyness 81(6.3%).Conclusion The main reasons of following up failure are outgoing,refusing return,financial problem,cases not found,hospitalization,transportation inconvenient and busyness.So we should strengthen health promotion of tuberculosis to enhance the patients'responsibility to their family and society.Health administration department should strengthen to intervene the reporting system and all the items should be filled in detail by medical institutes.Government should increase the finance input to help the poverty patients.Inpatients cases should be registered in detail so that to continue to receive the treatment in TB dispensary after they are out hospital.Strengthen the village and township hospitals'ability to the tuberculosis diagnosis and treatment for convenient to the patients.