归口管理对缩短新发涂阳肺结核诊断延迟的影响

目的　了解实施肺结核病人归口管理对涂阳肺结核病人诊断延迟的影响。方法 调查1993和 2001年肺结核病人归口管理检查和病人的卡片、病志等有关资料，分析归口管理前后诊断延迟情况。结果 归口转诊率由 48.5%，提高到 89.0%，归口到位率由 29.0%提高到 72.4%，确诊延迟率由 29.4%降到 10.6%，平均延迟天数由 22.2d降到 7.7d，就诊延迟率分别为 63.4%、68.8%和平均延迟天数分别为 48.9d、50.3d，延迟病人时间分布中 20周有一个高峰。结论 归口管理对缩短确诊延迟有明显影响，对就诊延迟无影响，加大结防宣传力度，提高群体对结防意识是缩短就诊延迟的关键。

Effect of newly smear positive tuberculosis delayed diagnosis with convergence case-management

Objective To research the effect of new smear positive tuberculosis delayed with convergence case-management in yanbian region.Methods To survey the data of pulmonary tuberculosis patient’s convergence case-management and their cards、medical records from 1993 to 2001 in yanbian, and analysed the effect on delayed diagnosis before and after implementing convergence case-management.Results Convergence transferring diagnosis rate raised from 48.5% to 89.0%, convergence successfully rate raised from 29.0% to 72.4%, while the rate of delayed diagnosis reduced from 29.4% to 10.6%, the average of delayed days reduced from 22.2 d to 7.7 d. On the other hand, the rate of delayed seeking medical advice was 63.4% and 68.8% respectively, and the average of delayed days was 48.9 d and 50.3 d respectively. there is a top-cusp at the 20th week in the date of delay.Conclusion Convergence case-management have significantly effect on delayed diagnosis, while have no effect on the delayed seeking medical advice.It is the key point that reduce delayed diagnosis dependent on improving people in mind to keep heath from tubercle.