陈洪, 白璐璐, 黄延, 佘敏, 张彬兵, 刘珊. 2016-2020年贵州省贵阳市不同类型医疗卫生机构诊断和报告肺结核患者的特征分析[J]. 疾病监测, 2022, 37(9): 1175-1180. DOI: 10.3784/jbjc.202203060087
引用本文: 陈洪, 白璐璐, 黄延, 佘敏, 张彬兵, 刘珊. 2016-2020年贵州省贵阳市不同类型医疗卫生机构诊断和报告肺结核患者的特征分析[J]. 疾病监测, 2022, 37(9): 1175-1180. DOI: 10.3784/jbjc.202203060087
Chen Hong, Bai Lulu, Huang Yan, She Min, Zhang Binbing, Liu Shan. Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Guiyang, Guizhou, 2016−2020[J]. Disease Surveillance, 2022, 37(9): 1175-1180. DOI: 10.3784/jbjc.202203060087
Citation: Chen Hong, Bai Lulu, Huang Yan, She Min, Zhang Binbing, Liu Shan. Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Guiyang, Guizhou, 2016−2020[J]. Disease Surveillance, 2022, 37(9): 1175-1180. DOI: 10.3784/jbjc.202203060087

2016-2020年贵州省贵阳市不同类型医疗卫生机构诊断和报告肺结核患者的特征分析

Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Guiyang, Guizhou, 2016−2020

  • 摘要:
      目的  通过分析2016—2020年贵州省贵阳市医疗卫生机构报告的肺结核患者报告卡,了解患者的就诊分布和诊断报告情况,为规范医疗机构肺结核患者的诊断、报告及管理提供依据。
      方法  通过“结核病管理信息系统”收集2016—2020年贵阳市医疗卫生机构报告的肺结核患者报告卡资料,采用描述性方法对其分布特征进行分析,各组间的比较采用χ2检验,P<0.05为差异有统计学意义。
      结果   2016—2020年,贵阳市共有177家医疗卫生机构报告了73 661张肺结核报告卡,其中28 085例确诊为肺结核,报告确诊肺结核患者的比例为38.13%。 定点医疗机构、非定点医疗机构及综合医院报告确诊肺结核患者的比例分别为48.32%、27.10%及28.10%,定点与非定点医疗机构确诊患者占报告数比例,以及定点医疗机构与综合医院确诊患者占报告数的比例,差异均有统计学意义(χ2=3 510.620,P<0.001;χ2 =2 671.605,P<0.001)。定点医疗机构报告确诊的患者数呈增加趋势(趋势χ2=41.917,P<0.001),而非定点医疗机构及综合医院报告确诊肺结核患者的比例均呈下降趋势(趋势χ2=1 099.635,P<0.001;趋势χ2=748.328,P<0.001)。 报告常住地患者49 345例(66.98%),非常住地患者24 316例(33.01%)。 常住地患者主要就诊于县级定点医院(17 113例,34.68%) 及综合医院(15 713例,30.75%);非常住地患者主要就诊于综合医院(11 403例,46.90%)及市级定点医院(9 747例,40.08%);与2016年比较,2020年常住地及非住地患者就诊于综合医院的比例分别增加了100.42%及261.44%。 常住地患者的登记管理率为75.57%,非常住患者的为47.23%,差异有统计学意义(χ2=2 098.567,P<0.001);贵阳市远城区登记管理率最高(82.81%),其次是近城区(70.66%),主城区最低(66.66%);2016—2020年主城区登记管理率提高明显(趋势χ2=572.661,P<0.001),近城区则呈降低趋势(趋势χ2=65.287,P<0.001),远城区较平稳。
      结论  各级医疗卫生机构应加强结核病诊断能力建设,强化技术培训,提高医务人员肺结核诊疗水平;同时,应持续进行结核病防治知识的健康宣传,提高患者医从性,规范肺结核患者的治疗和管理。

     

    Abstract:
      Objective  To analyze the reporting cards of pulmonary tuberculosis (TB) reported by medical and health institutions in Guiyang of Guizhou province, understand the characteristics of pulmonary TB distribution and reporting ,and provide evidence for standardizing TB diagnosis and reporting in medical institutions.
      Methods  Through National Special Reporting System for TB, the incidence data of pulmonary TB in Guiyang from 2016 to 2020 were collected and analyzed by descriptive epidemiology method. The differences among groups were compared with χ2 tests.
      Results  A total of 73 661 pulmonary TB cases were reported by 177 medical and health institutions in Guiyang from 2016 to 2020, of which 28085 were confirmed cases, accounting for 38.13% of the total cases. The proportions of confirmed pulmonary TB cases in designated and non-designated medical institutions and general hospitals were 48.32%, 27.10% and 28.10% respectively. There was significant difference in the proportion of the cases diagnosed in designated and non-designated medical institutions (χ2=3510.620, P<0.001). There was also significant difference in the proportions of the cases diagnosed in designated medical institutions and general hospitals (χ2=2671.605, P<0.001). Compared with 2016, the number of the confirmed cases reported by designated medical institutions showed an increasing trend (trend χ2=41.917, P<0.001). However the proportions of the confirmed cases reported by non-designated medical institutions and general hospitals showed downward trends (trend χ2=1099.635, P<0.001; trend χ2=748.328, P<0.001). In reported pulmonary TB cases, 49 345 were local residents in Guiyang (66.98%) and 24316 were non- local residents (33.01%). The pulmonary TB cases in local residents were mainly reported by county-level designated medical institutions (17113 cases, 34.68%) and general hospitals (15713 cases, 30.75%), the pulmonary TB cases in non-local residents were mainly reported by general hospitals (11403 cases, 46.90%) and municipal-level designated medical institutions (9747 cases, 40.08%). From 2016 to 2020, the number of the patients who visited municipal designated hospitals in local and non-local residents increased year by year. The registration management rate of the local and non-local cases were 75.57% and 47.23%. The difference was significant (χ2=2098.567, P<0.001). The registration management rates of pulmonary TB cases in different urban areas of Guiyang were different, it was highest (82.81%) in the far urban area, followed by the near urban area (70.66%) and main urban area (66.66%). During 2016−2020, the registration and management rate of the cases were significantly improved in the main urban area (trend χ2=572.661, P<0.001), but it showed a downward trend in the near urban area (trend χ2=65.287, P<0.001), and remained stable in far urban area.
      Conclusion  Medical and health institutions at all levels should strengthen the capacity building of pulmonary TB diagnosis, strengthen technical training to improve the diagnosis and treatment of pulmonary TB; At the same time, health education about pulmonary TB prevention and control should be continued, the patient compliance should be improved and the treatment and management of pulmonary TB cases should be standardized.

     

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