中国防痨杂志2024，Vol.46Issue(4)：418-423,6.DOI:10.19982/j.issn.1000-6621.20230340
浙江省龙游县肺结核诊疗"零负担"策略实施效果评估
Evaluation of the implementation effect of the"Zero Burden"strategy for diagnosis and treatment of pulmonary tuberculosis in Longyou County,Zhejiang Province
摘要
Abstract
Objective:To compare the changes in tuberculosis prevention and control indicators before and after the implementation of the"Zero Burden"strategy for tuberculosis diagnosis and treatment in Longyou County,Zhejiang Province,in order to provide scientific basis for formulating new tuberculosis prevention and control measures in a new stage.Methods:The reported incidence data of tuberculosis in all counties(cities,districts)of Quzhou City and counties bordering Longyou County(including Suichang County,Lanxi City,Wucheng District,and Jiande City)in Zhejiang Province from 2016 to 2022,as well as the admission rate and treatment outcome data of tuberculosis patients currently residing in Longyou County,were collected through the Tuberculosis Management Information System,a subsystem of China Disease Prevention and Control Information System.The number of permanent residents came from the local statistical yearbook.The data of diagnosis and treatment cost of pulmonary tuberculosis patients in Longyou County were from the information management system of Longyou County People's Hospital.The interruption rate of treatment and policy satisfaction of pulmonary tuberculosis patients were mainly collected through surveys conducted by follow-up doctors in designated hospitals and community.Compare the diagnosis and treatment costs of tuberculosis patients,reported incidence rate of tuberculosis,admission rate of the county,treatment outcome and other indicators before(2016-2018)and after(2020-2022)the implementation of the"Zero Burden"strategy for tuberculosis diagnosis and treatment in Longyou County,and analyzed the implementation effect of the strategy.Results:Before the implementation of the"Zero Burden"strategy,the total personal payment expenses for tuberculosis patients were RMB 830 322.45 yuan in 2016,RMB 833 450.10 yuan in 2017,and RMB 792 879.99 yuan in 2018.The personal payment expenses per tuberculosis patient were RMB 3075.27 yuan in 2016,RMB 3281.30 yuan in 2017 and RMB 3523.91 yuan in 2018.After the implementation of the"Zero Burden"strategy,the proportion of personal payment expenses for ordinary tuberculosis patients decreased to 0,and the county's financial support expenses decreased year by year(RMB 492 160.29 yuan,RMB 401 349.56 yuan,and RMB 389 319.42 yuan respectively from 2020 to 2022).The reported incidence rate of pulmonary tuberculosis in Longyou County was 74.17/105(270/364 0 00)in 2016,and decreased to 47.21/105(169/3 5 8 0 00)in 2022,the difference was statistically significant(x2Trend=43.962,P＜0.001);the local admission rate of reported pulmonary tuberculosis patients had significantly increased from 74.81％(202/270)in 2016 to 93.49％(158/169)in 2022(x2Trend=64.483,P＜0.001);and the reported interruption rate of treatment for pulmonary tuberculosis patients significantly decreased from 6.30％(17/270)in 2016 to 1.18％(2/169)in 2022(x2Trend=17.965,P=0.003).Conclusion:The implementation of the"Zero Burden"strategy for tuberculosis diagnosis and treatment in Longyou County,Zhejiang Province reduced the medical burden of tuberculosis patients,increased the local admission rate,reduced the rate of patients'treatment interruption and the overall reported incidence rate of tuberculosis,and the implementation effect of the strategy has appeared tentatively.关键词
结核,肺/费用,医疗/卫生政策/评价研究Key words
Tuberculosis,pulmonary/Fees,medical/Health policy/Evaluation studies分类
医药卫生引用本文复制引用
王莉燕,周慧,吴倩,郝晓刚,陆冰欣,陈彬..浙江省龙游县肺结核诊疗"零负担"策略实施效果评估[J].中国防痨杂志,2024,46(4):418-423,6.基金项目
国家卫生健康委-浙江省卫生健康委省部共建基金项目(WKJ-ZJ-2118) （WKJ-ZJ-2118）
浙江省软科学研究计划(2024C35082) The Provincial and Ministerial Joint Research Project of the National Health Commission and the Zhejiang Provincial Health Commission(WKJ-ZJ-2118) （2024C35082）
Zhejiang Province Soft Science Research Program(2024C35082) （2024C35082）
