上海市普陀区社区肺结核综合管理模式的建立与实践

目的 通过分析和评价上海市普陀区社区肺结核标准化管理规范实施情况和取得的成效,探讨特大型城市社区肺结核防治模式的可持续发展机制。方法 以普陀区各社区卫生服务中心为现场,采用现有资料收集、问卷调查方法进行定量研究。结果 普陀区社区肺结核管理规范在辖区得到有效实施,社区标准化管理系列手册得到社区医生及肺结核病患者的支持。2011-2015年,普陀区肺结核新登记率呈下降趋势,新涂阳治愈率均达到85.00%以上,疑、确诊肺结核病总体追踪到位率均达90.00%以上,密切接触者筛查率为100.00%。对患者的手册发放率达100.00%,患者手册使用率达90.87%。医务人员对手册的满意率为100.00%,其中有40.98%满意程度为满分。结论 普陀区社区肺结核病综合管理模式有效落实过程管理,量化各项工作内容,建立效果评价体系并为患者提供有效的卫生干预,取得了较好的管理效果。

Establishment and implementation of community integrated mode of tuberculosis control in Putuo District of Shanghai

Objective To explore the mechanism for sustainable community tuberculosis control mode in mega-cities by analyzing and evaluating the implementation of standardized management practices in Putuo District, Shanghai.Methods Quantitative research including analyzing data obtained from national TB registration system and a questionnaire survey in 10 community health service centers was conducted.Results Standardized community TB management practices in Putuo District was effectively implemented, and the standardized management series manuals were supported by community physicians and pulmonary TB patients. Newly registered TB rate declined from 2011 to 2015; the cure rate of new smear positive TB patients was 85.00%, overall tracking rate of suspected or diagnosed TB patients was over 90.00%; screening rate of close contacts with TB patients was 100.00%; standardized manuals were distributed to 100.00% patients, and was utilized by 90.87% of them; 100.00% community physicians were satisfied with the standardized manuals, of whom 40.98% scored the highest satisfaction level.Conclusion Community tuberculosis control mode was effectively implemented in Putuo District through process management, job content quantification, evaluation system establishment, and high quality health intervention.