云南省不同地区肺结核转诊追踪措施效果分析

[目的]比较肺结核转诊追踪措施在云南省不同地区的实施效果差异,为进一步完善结核病防治服务体系提供依据。[方法]利用疾病监测信息报告管理系统和肺结核专报系统,回顾性收集昆明市、玉溪市和昭通市2006-2011年肺结核患者转诊追踪信息和肺结核患者发现资料,计算并比较三市肺结核患者转诊到位率、追踪到位率、总体到位率和确诊患者来源构成比。[结果]2011年云南省患者总体到位率大幅上升至87.45%,其中追踪到位率上升最为明显。玉溪市、昭通市、昆明市转诊到位率分别为56.53%,28.86%和24.54%,追踪到位率分别为48.85%,36.63%和34.41%,差异有统计学意义(P0.001)。玉溪市58.92%患者来自转诊措施,昭通市57.81%患者来自主动就诊,而昆明市32.99%患者来自追踪措施。[结论]转诊追踪措施在经济发展和医疗资源配置不同的地区,实施效果不尽相同,应鼓励各地应用不同模式为肺结核患者提供诊治服务。

Effect analysis on referral and tracing measures of pulmonary tuberculosis in different regions of Yunnan province

Objective To provide the basis for further completion of Tuberculosis （TB） prevent and control system, through comparing effect difference under carrying out TB referral and tracing measures in different regions of Yunnan province. Methods Retrospectively collecting data of TB cases detection, referral and tracking in cities ofKtmming, Yuxi and Zhaotong from 2006 to 2011, through disease monitoring information system and TB special report system. Calculates and compares the proportion of referral, tracking, overall arrival rates and the patients source among three cities. Results The overall arrival rate of TB referral and tracking in Yunnan was soared to 87.45%, with the most obvious rise appeared on tracking rate. The arrival rate of referral was 56.53%, 28.86% and 24.54% respectively in Yuxi, Zhaotong, Ktmming, and arrival rate of tracking was 48.85%, 36.63% and 34.41% respectively, with statistic significance（P〈0.001）. 58.92% TB cases came from referral measure in Yuxi, and 57.8 1%TB cases came from visiting doctors initiatively in Zhaotong, while 32.99% TB cases in Kunming came from tracking measure. Conclusions There were different effect of implementation for referral and tracking measurement among different economic development and medical resource allocation areas, then different service modes for TB cases detection and treatment should be encouraged.