【摘要】 目的了解定点医院防治模式下结核病患者的满意度,并为定点医院防治模式的改进提供依据。方法选取全球基金结核病项目2009年10月启动定点医院模式的40个县(区)级定点医院作为研究现场,通过病案查询了解诊疗信息,通过问卷调查了解患者满意度情况。共发放问卷907份,最终收回有效问卷795份,问卷有效率为99.38%。采用卡方检验的统计分析方法,比较不同类型患者的满意度,P<0.05为差异有统计学意义。结果94.65%(752/795)的患者愿意推荐患结核病的亲友到定点医院就诊,患者对定点医院各方面满意度从高到低依次是医疗技术(86.79%,690/795)、服务态度(86.79%,690/795)、健康宣传教育(简称"宣教")(83.02%,660/795)、就诊流程(76.60%,609/795)、门诊环境(73.84%,587/795)、宣教效果(73.21%,582/795)和费用承担(41.89%,333/795)。涂阳患者在医疗技术、宣教效果、费用负担方面的满意度(82.76%,264/319;69.59%,222/319;36.99%,118/319)均低于涂阴患者的满意度(89.43%,423/473;75.90%,359/473;45.45%,215/473)(χ2值分别为7.371、4.673、5.436,P值均<0.05)。服药时有人督导的患者对健康宣教的满意度(84.16%,558/663)高于无人督导的患者(75.76%,100/132)(χ2=4.195,P<0.05)。服药时有人督导的患者能承担费用的比例(39.06%,259/663)低于无人督导的患者(55.30%,73/132)(χ2=12.944,P<0.001)。结论结核病患者对定点医院模式总体比较认可,但定点医院仍需改进门诊环境和就诊流程,落实结核病诊治优惠政策,进一步提高患者的满意度。更多还原

【Abstract】 Objective To understand the satisfaction degree of tuberculosis(TB)patients on designated hospitals,and to provide reference for designated hospital model improvement.Methods Forty designated hospitals in which designated hospital model launched in October 2009 in Global Fund TB program area were enrolled in this study.907 questionnaires were sent to TB patients and 795 effective questionnaires were retrieved,and the effective rate of questionnaire was 99.38%.TB patients’ information of diagnosis and treatment were attained through medical record and satisfaction degree on designated hospitals through questionnaires.The satisfaction degree of different types of patients was compared by chi-square test,0.05 was set as the criteria of statistically significant difference.Results Of 795 TB patients,94.65%(752/795)of the patients wanted to recommend designated hospital to their relatives with TB.The diminishing sequence of satisfaction degree on all aspects of designated hospitals was medical technology(86.79%,690/795),service attitude(86.79%,690/795),health promotion(83.02%,660/795),treatment process(76.60%,609/795),outpatient environment(73.84%,587/795),effect of health promotion(73.21%,582/795)and expenses(41.89%,333/795).The satisfaction degree of sputum smear positive TB patients on medical technology,effect of health promotion and expenses(82.76%,264/319;69.59%,222/319;36.99%,118/319)were all lower than those of sputum smear negative TB patients(89.43%,423/473;75.90%,359/473;45.45%,215/473)(χ2 values were 7.371,4.673and 5.436 respectively,and all P values were lower than 0.05).TB patients supervised taking medicine had higher satisfaction degree on health promotion(84.16%,558/663)than those without supervision(75.76%,100/132)(χ2=4.195,P<0.05).The proportion of affordable expenses of TB patients supervised taking medicine(39.06%,259/663)was lower than those without supervision(55.30%,73/132)(χ2=12.944,P<0.001).Conclusion Although the designated hospital model obtains the approval of most of TB patients,it still needs to improve the outpatient environment and treatment process,and to carry out the free diagnosis and treatment policy for TB patients,in order to further improve the TB patients’ satisfaction.更多还原