山西省肺结核防控激励机制及相关态度行为调查分析

发布时间：2018-04-15 00:39

本文选题：肺结核 + 激励机制　；参考：《山西医科大学》2012年硕士论文

【摘要】：目的：探究激励机制在肺结核病二级预防中的作用,为出台有效激励政策提供经验和证据。方法：本文采用回顾性分析,资料来源于2004年11月至2005年10月山西省50个实施FIDELIS项目(通过为新涂阳肺结核患者提供交通补助促进患者主动求诊,进而提高患者发现、治疗管理水平)县(区)中的4个。收集基线年(无激励措施)与项目年(有激励措施)常规监测新涂阳肺结核患者数据进行比较,采取分层整群抽样结防人员、村医及村干部、肺结核病患者与可疑者进行问卷调查,运用相对数进行描述,行×列表资料对比采用χ2检验,通过SPSS11.5软件完成统计学分析。结果：①项目年与基线年相比,新涂阳肺结核病患者发现人数提高了85.28%,11-5月的7个月内,基线年统计结果均小于当月项目年的发现人数,最高的一个月相差86人,最少的也相差7人,提示激励政策提高了新涂阳肺结核患者的发现率,对防控工作具有一定效果。②对肺结核患者发现工作中采取的激励机制,94.87%结防人员持赞成态度,98.68%村医及村干部持赞成态度,对肺结核患者的发现、治疗等起到积极作用。③结防人员、村医及村干部、肺结核患者与可疑者3类人群对激励机制中的具体措施有不同看法,但在有奖报病等问题上一致赞同。④在有效调查的377人中,有76人认为项目年实行的激励标准较低,有212人认为项目年实行的激励标准合适,有89人对项目年实行的激励标准持无所谓态度。3类人群对激励标准看法不同,(χ2=103.2,P0.001)。⑤对项目县实行激励政策,有78.5%的调查对象对此政策表示满意,有21.5%的调查对象表示不满意。3类人群对激励措施满意度不一。(χ2=14.49,P0.001)。⑥医务人员对激励标准：县级结防人员对督导管理初治涂阳或重症涂阴肺结核患者预期补助比国家标准高出60元,村级高出40元；县级结防人员对督导管理初治涂阴肺结核患者预期补助比国家目前标准高出50元,村级高出40元。可见各人群对物质奖励持较高期望值。结论：①激励机制在肺结核病二级预防中起到了积极作用,应该继续深入推广。②对激励机制实施过程中的一些具体措施,不同人群提出了建设性意见。可见在制定政策时,应该结合实际,权衡利弊,充分发挥激励机制的作用。③应该加强项目监督管理,合理化办事程序,使各项措施真正落实到位,提高激励机制的效益。
[Abstract]:Objective: to explore the role of incentive mechanism in the secondary prevention of pulmonary tuberculosis and provide experience and evidence for effective incentive policy.Methods: by retrospective analysis, 50 FIDELIS projects were implemented in Shanxi Province from November 2004 to October 2005.Treatment management level) 4 of county (district).To collect baseline year (no incentive measures) and project year (with incentive measures) routine monitoring of new smear positive pulmonary tuberculosis patients data were compared, stratified cluster sampling, village doctors and village cadres,The pulmonary tuberculosis patients and suspicious persons were investigated by questionnaire, the relative numbers were used to describe the data, the X list data were compared by 蠂 2 test, and the statistical analysis was completed by SPSS11.5 software.Results in comparison with baseline year, the number of new smear positive pulmonary tuberculosis patients was increased by 85.28 months in November to May. The statistical results of baseline year were all smaller than those of project year in that month, the highest difference was 86 in one month.The smallest difference was 7, suggesting that the incentive policy had increased the detection rate of new smear positive TB patients.It has certain effect on the prevention and control work. 2. The incentive mechanism adopted in the discovery of pulmonary tuberculosis is 94.87%. 98.68% of the village doctors and village cadres are in favor of the attitude, and the finding of pulmonary tuberculosis patients is in favor of 98.68% of the village doctors and village cadres.Treatment played a positive role. 3. The three groups of people, such as village doctors and village cadres, pulmonary tuberculosis patients and suspicious people, had different views on the specific measures in the incentive mechanism.However, there was unanimous agreement on issues such as the award reporting of illness. Of the 377 people effectively surveyed, 76 considered that the incentive standard applied in the project year was low and 212 considered that the incentive standard applied in the project year was appropriate.89 people were indifferent to the incentive standard adopted in the project year. 3 groups of people had different views on the incentive standard (蠂 2 103.2g / P 0.001.5). 78.5% of the respondents were satisfied with the incentive policy, and 78.5% of the respondents were satisfied with the policy.21.5% of the respondents indicated that they were not satisfied with the incentive measures. (蠂 ~ 2 ~ 2 ~ (14.49) P _ (0.001) ~ (.6)): the county-level knockout prevention staff's expected subsidy to the newly treated smear positive or severe smear tuberculosis patients was 60 yuan higher than that of the national standard.The village level is 40 yuan higher than the village level; the county level knockdown prevention personnel to supervise and manage the initial treatment of smear smear tuberculosis patients expected subsidies than the current national standard is 50 yuan higher than the village level 40 yuan.It can be seen that all groups of people hold high expectations for material rewards.Conclusion the incentive mechanism of "1" has played an active role in the secondary prevention of pulmonary tuberculosis, and some concrete measures in the process of implementing the incentive mechanism should be further popularized, and some constructive suggestions have been put forward by different groups of people.It can be seen that when making policies, we should combine the reality, weigh the advantages and disadvantages, give full play to the role of the incentive mechanism. .3 should strengthen the supervision and management of the project, rationalize the working procedures, make all measures really put into place, and improve the efficiency of the incentive mechanism.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R521

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