中国防痨杂志2024，Vol.46Issue(2)：199-205,7.DOI:10.19982/j.issn.1000-6621.20230373
"十三五"期间广州市不同结核病防治管理模式实施效果评价
Evaluation on the implementation effect of different tuberculosis prevention and control management models during the 13th Five-Year Plan period in Guangzhou
摘要
Abstract
Objective:To evaluate the implementation effect of the existing tuberculosis management mode in Guangzhou,and to provide the evidence and examples for improving the tuberculosis prevention and control service system.Methods:From 2016 to 2020,the tuberculosis epidemic data under four tuberculosis prevention and control management models(chronic disease management model,"trinity"model,general hospital management model and entrusted service mode)in Guangzhou were collected from the tuberculosis surveillance information reporting management system of Guangzhou and the final evaluation report of the 13th Five-Year Plan for tuberculosis prevention and control in Guangzhou.The registration rate,etiological positive rate,successful treatment rate,management rate and standardized management rate of pulmonary tuberculosis patients under different modes were calculated,and the cost-effectiveness analysis of the implementation effect was carried out.Results:In 2016-2020,the average annual registration rate of tuberculosis in Guangzhou was 51.78/100 000(46 228/89 280 200),the average annual registration rate of the four models from high to low,was entrusted service mode(74.37/100 000(10 522/14 148 900)),"trinity"(50.17/100 000(11 349/22 619 500)),chronic disease management(47.37/100 000(14 588/30 793 700))and general hospital management(44.98/100 000(9769/21 718 100)),statistically significant difference(x2=222.422,P＜0.001).The total etiological positive rate was 49.33％(22 806/46 228),the rate of chronic disease management model was the highest(50.98％(7437/14 588)),and the entrusted service model was the lowest(48.07％(5058/10 522));the overall treatment success rate was 93.26％(43 113/46 228),the rate of general hospital management model was the highest(95.73％(9352/9769)),and the"trinity"model was the lowest(90.30％(10 248/11 349));the total standard management rate was 89.08％(13 254/14 879),the rate of entrusted service mode was the highest(95.40％(2573/2697)),and the"trinity"model was the lowest(82.69％(3100/3749));the differences were statistically significant(x2=27.302,P＜0.001;x2=306.666,P＜0.001;x2=294.272,P＜0.001).The per capita investment was 0.86 yuan(76 477 200/89 280 200),the maximum investment for one DALY loss was the"trinity"model(RMB 188.20 yuan(20 326 600/108 003.67)),and the general hospital management model is the lowest(153.77 yuan(15 155 800/98 560.73)).Conclusion:During the period,the four tuberculosis control management models in Guangzhou have its own advantages and disadvantages.In the future,it is still necessary to take active measures to improve the deficiencies in the existing tuberculosis prevention and control service system based on the demand orientation of various districts,from government departments,systems to talent construction,so as to further improve the patient registration rate,the etiological positive rate and the total standardized management rate.关键词
结核/管理医疗规划/公共卫生管理/结果评价(卫生保健)/广州市Key words
Tuberculosis/Managed care programs/Public health administration/Outcome assessment(health care)/Guangzhou City分类
医药卫生引用本文复制引用
郑光敏,王挺,张丹妮,雷宇,杨洁莹,吴桂锋,杜雨华,肖新才.."十三五"期间广州市不同结核病防治管理模式实施效果评价[J].中国防痨杂志,2024,46(2):199-205,7.基金项目
广州市科技计划项目(2023B03J1303) （2023B03J1303）
广州市卫生健康科技重大项目(2020A031003) （2020A031003）
广州市医学重点学科(2021-2023)结核病学Guangzhou Science and Technology Plan Project(2023B03J1303) （2021-2023）
Guangzhou Health Science and Technology Major Project(2020A031003) （2020A031003）
Guangzhou Medical Key Discipline(2021-2023)Tuberculosis Science （2021-2023）
