以街道社区卫生服务中心为主导的肺结核患者督导管理模式效果研究

目的 探讨以街道社区卫生服务中心为主导的肺结核患者督导管理模式所取得的效果。方法 选择2016年10月 - 2018年3月在林校社区完成服药管理的肺结核患者87例为病例组，选择未施行街道社区卫生服务中心督导管理之前（2015年1月 - 2016年9月之间）住址归属于林校社区管理的完成服药管理的肺结核患者90例为对照组，对照组患者由区级结核病预防控制中心相关人员完成督导过程，病例组患者由社区卫生服务中心人员完成督导过程，对比干预的效果。结果 2组患者的不良反应及时发现率数据差异无统计学意义（χ2 = 1.901，P＞0.05），病例组患者的首次面访率、周访合格率、规律服药率、治愈率均高于对照组患者，数据差异均具有统计学意义（χ2 = 10.735、12.679、12.670、7.563，P＞0.05），病例组患者的治疗依从性和管理满意度优于对照组患者，数据差异具有统计学意义（z = - 9.077，-7.553，P＜0.05），每名结核病管理医务人员每周管理每名患者的平均时间在不同时间点的数据差异具有统计学意义（F = 84.588，P＜0.05），每名结核病管理医务人员每周管理每名患者的平均时间逐渐上升（rs = 0.783，P＜0.05）。结论 以街道社区卫生服务中心为主导的肺结核患者督导管理模式可以提升管理效果，但是应注意医生的人力消耗在不断增加的情况，并以更加科学的方式对该种模式进行管理。

Effect of supervision and management model on tuberculosis patients in street community health service center

Objective The aim of this study was to explore the effectiveness of the supervision and management model for tuberculosis patients led by street community health service centers. Methods 87 cases of tuberculosis patients were selected from October 2016 to March 2018 in the community of forest school. And 90 cases of tuberculosis patients who had not implemented the supervision and management of the community health service center (between January 2015 and September 2016) belonging to the community management of the forest community were selected as the control group. The patients in the control group completed the process of supervision by the people related to the district level tuberculosis control, and the patients in the case group completed the supervision process by the community health service center. The effects of the intervention were compared. Results The two groups of patients had no significant difference in the rate of adverse reactions and timely detection(χ2=1.901, P>0.05). The rate of first visit, the rate of weekly visit, the rate of regular medication and the cure rate were higher in the intervention group than those in the control group, and the difference of data was statistically significant(χ2=10.735, 12.679, 12.670, 7.563, P>0.05). The compliance and management satisfaction of patients in the case group were better than those in the control group, and the difference was statistically significant(z=-9.077, -7.553, P<0.05). The average time for each patient to manage per week at different time points was statistically significant (F=84.588, P<0.05). The average time of weekly management of each patient was increased gradually(rs=0.783, P<0.05). Conclusion The management model of tuberculosis patients led by street community health service center can improve the management effect. However, attention should be paid to the increasing need of doctors and the management of the model in a more scientific way.