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目的分析实施肺结核门诊辅助诊疗单病种付费项目对患者发现和治疗的影响,为项目实施提供依据。方法比较隆回县项目实施前1年(2011年)和实施期间(2012年)肺结核病人初诊就诊率、病人发现率和丢失率,评价项目实施对患者发现和治疗管理的影响。结果项目实施期间病人的初诊就诊率293.60/10万,较实施前的237.61/10万增长23.6%;活动性肺结核患者发现率实施期间73.8/10万,实施前66.0/10万,发现数增长10.8%;患者丢失率从实施前的1.0%减少为0。项目实施前肺结核患者新农合基金补偿为363 221元/年,实施后为768 780元/年,增加了111.7%。结论肺结核门诊辅助诊疗单病种付费项目提高了病人发现水平,减少了病人丢失,对病人的规范治疗管理有促进作用,可推广实施。
Objective To analyze the impact of the implementation of pay-for-the-item program on the diagnosis and treatment of single disease in the outpatient clinic of tuberculosis and provide the basis for the implementation of the project. Methods The first visit (2011) and the implementation period (2012) of the patients in the Longhui County before the implementation of the project were compared with the initial visit rate, the detection rate and the loss rate of the TB patients, and the impact of the implementation of the project on patient discovery and treatment management. Results The number of newly diagnosed cases was 293.60 / lakh during the implementation of the project, up 23.6% from 237.61 / lakh before implementation. The detection rate of active pulmonary tuberculosis was 73.8 / lakh during the implementation period and 66.0 / lakh before implementation, and the number of discoveries increased by 10.8 %; Patient loss rate decreased from 1.0% before implementation to 0%. Before the implementation of the project, the compensation of new rural cooperative medical fund for tuberculosis patients was 363 221 yuan per year, after implementing it 768 780 yuan per year, an increase of 111.7%. Conclusion Pay-for-the-item project of auxiliary diagnosis and treatment of tuberculosis clinics can improve the level of patient discovery, reduce the loss of patients and promote the standard treatment and management of patients, which can be promoted and implemented.