卫生院督导为主的管理模式效果评价.docVIP

PAGE PAGE 1 卫生院督导为主的管理模式效果评价 　 赵亚玲1　葛利辉1 危国强2　　蒙福荣2　　 （1广西南宁市疾病预防控制中心　南宁530011 2　广西武鸣县疾病预防控制中心　武鸣　530100；） 摘要：目的　探讨肺结核病人定期到卫生院领取抗结核药，同时接受卫生院督导为主的管理模式实施效果。方法　县疾控中心结防门诊医生与病人鉴定治疗管理协议书，病人在强化期和巩固期分别每6天和10天到卫生院取药一次，同时接受卫生院结防医生督导，对完成疗程的病人，每例给20元的交通补助。 结果　新的管理模式实施后，乡镇卫生院结防人员对病人的访视次数由旧模式的4次/例，提高到新模式的17次/例，涂阳及初治重症涂阴病人规则治疗率由旧模式的71.5%提高到新模式的82.7%，治疗成功率及新发涂阳治愈率分别由旧模式的86.3%、88.5%提高到新模式的88.3%，90.4%。 结论　新的督导模式，提高了病人规则治疗率及督导质量，在目前卫生院督导人员不足的情况下，采用病人定期到卫生院取药和接受督导的管理方式，是对结核病管理模式的有益改良和补充。 关键词：结核，肺/预防和控制　督导模式 Evaluation of the performance effect of management mode supervised by community hospitals predominantly ZHAO Ya-lin1, GE Li-hui1, Wei guojiang2 Mong furong1 (1.Nanning Center for Disease Control and Prevention Nanning 530011,Guangxi, China. 2. Wuming Center for Disease Control and Prevention,Guangxi, Nanning 530100 China ) Abstract： Objective To study the performance effect of tuberculosis patients taking anti-TB drugs from community hospitals regularly and the management mode supervised by community hospitals predominantly. Methods According to the agreements signed between doctors from country CDC and tuberculosis patients, the tuberculosis patients should take the anti-TB drugs from communication hospitals every 6 days on initial intensive treatment period and every 10 days on consolidation treatment period respectively, while they should implement DOT strictly. 20 RMB was given to each patient with completion of treatment as a transport subsidy. Results After the new management mode, the frequency that doctors from community hospitals visited tuberculosis patients had been increased from 4 times per case to 17 times per case. The rate of normative treatment of smear positive patients and initial smear negative patients with severe had been raised from 71.5% to 82.7%. The success rate and the cure rate of new smear positive TB cases had been improved from 86.3%, 88.5% to 88.3%， 90.4% respectively. Conclusions The rate of normative treatment and the quality of su