上海市闵行区结核病治疗费用减免方案运行效果分析

目的对上海市闵行区结核病防治减免政策的效果进行评价，为进一步控制结核病提供依据。方法分析闵行区疾病预防控制中心1997—2003年结核病登记资料和闵行区结核病定点医院2004年住院肺结核病人医疗费用．对该定点医院2001—2003年间结核病治疗费用减免方案实施前后外来人口结核病人X胸片重新读片和作病理分类．结果闵行区结核病防治减免方案实施1年多来已初显成效。2003年底新登记外来人口结核病病人数较2002年增加19．9％．其中外报病人比例下降29．0％，定点医院治疗的外来人口结核病痛人则增加3．7倍，其化疗覆盖率达95．6％，化疗督导管理率达84．1％；外来人口结核病病人失访率下降为3．5％，实际治愈率已达78．8％。结论闵行区的减免政策促进了结核病病人的发现和归口治疗管理。解决跨地区结核病患者的管理问题也是控制外来人口结核病的一个关键。

The Operating Effect of Remission Plan About TB Control in Minhang District, Shanghai

OBJECTIVE To evaluate the effect of the remission policy about TB control in Minhang District,Shanghai,and to make suggestions for further TB control.METHODS Collecting and analyzing the TB registration data in Minhang CDC from 1997 to 2003 and the medical expense of TB inpatients in special hospital in 2004 and the data on chest X-ray of TB migrant patients from 2001 to 2003. RESULTS Improvement in TB control for migrants has been made since the remission plan was trial-operated in January,2003.In domestic migrants,the number of newly registered TB patients was increased about 19.9%,the percent of TB patients reported from other districts was decreased about 29.0%,and the number of TB patients diagnosed in TB special hospitals was increased about 3.7 times by the end of 2003,compared with that of 2002.The percent of TB migrant patients treated by chemotherapy and supervised was 95.6% and 84.1%,respectively.The percent of TB migrant patients who lost follow-up was decreased about 3.5%,and the cure rate of TB migrant patients was 78.8%.CONCLUSIONS The remission policy helped the TB patients in early diagnosis and monitoring of the treatment process.