烟台市行政干预措施对提高肺结核发现率的效果分析

目的　总结实施综合干预措施对提高肺结核患者发现率的影响。方法 强化行政与技术措施干预,广泛深入地宣教,落实归口管理,结合主动发现及考核、评价、奖惩等综合干预措施,并对干预前后进行调查、统计、对比。结果 综合医疗机构的肺结核及疑似肺结核病人转诊率由干预前1993年的53.2%上升至干预后2001年的98.6%;活动性肺结核患者发现(新登记)率由干预前1993年的1755/10万上升至干预后2001年的3038/10万;涂阳肺结核患者发现(新登记)率由干预前1993年的607/10万上升至干预后2001年的1794/10万(χ²=57.73,P<0.001),有非常显著性差异。采取干预措施后的8年(1994-2001年)新登记的涂阳病人,比干预前的8年(1986-1993年)增加了12.78%(7097/3186)。结论 烟台市对肺结核患者发现实施综合干预措施,并规范疫情登记、转诊、报告工作,有效提高了肺结核患者发现(新登记)率。

Analysis on effect of increasing the detection rate of TB patients by administrative intervenient measures in Yantai City

Object To explore the effect of comprehensive intervenient approaches on increasing TB patient detection. Meathod Comprehensive intervenient measures have been taken by strengthening the intervention of administrative and technical measures, making wide and deep propaganda and health education, strengthening case referring from hospitals , combining active finding , evaluation , incentive and punishment. The case finding data was analyzed before and after interventions. Result The referring rate of TB cases from hospitals increased from 53 2% in 1993 before the interventions to 98 6% in 2001 after the interventions. The newly registered active TB patients rate increased from 17 5/100,000 in 1993 before the interventions to 30 4/100,000 in 2001 after the interventions. The new registration of smear positive cases rate increased from 6 1/100,000 in 1993 before the intervention to 17 9/100,000 in 2001 after the intervention (X2=57 73 P <0 001), the difference was significant . During the 8 years (1994-2001) with intervenient measures, newly registered smear positive cases rate were 127 8% more than that of the 8 years (1986-1993) before taking intervenient measures. Conclusion The city has taken comprehensive intervenient measures for the detection of TB patients, the registration, referring and reporting work were improved , which effectively increased the new registration of TB patients.