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目的:运用定性研究方法找出重庆地区肺结核病人低发现率的主要影响因素,为提出有效的病人发现模式提供依据,提高病人发现率。方法:采用了问题分析和矩阵排序、个人深入访谈、专题小组讨论等多种定性研究的方法,对包括结防专业机构的医护人员、结核病现症病人等进行了采访。结果:政府财政投入不足、高危人群筛查工作开展不足、医疗费用过高、交通不便等因素是制约重庆市结核病人发现工作的主要因素,其中政府财政投入不足影响最大。结论:采用问题分析和矩阵排序的方法明确了不同的因素对病人发现的影响程度。只有更好地落实政府承诺,加强结防机构自身建设,定期开展高危人群的筛查工作及加强归口管理工作,才能够切实地提高病人发现水平。
OBJECTIVE: To identify the main influencing factors of low detection rate of pulmonary tuberculosis patients in Chongqing by qualitative research methods, and to provide evidences for the effective pattern of patient discovery and improve the detection rate of patients. Methods: Various qualitative research methods such as problem analysis and matrix sorting, personal in-depth interviews, and panel discussion were used to interview health care workers and patients with TB disease, including specialized agencies for the prevention and treatment of tuberculosis. Results: Inadequate government financial investment, lack of screening for high-risk groups, excessive medical expenses and inconvenient transportation were the main factors restricting the discovery of tuberculosis patients in Chongqing. Among them, the government’s fiscal underinvestment had the greatest impact. Conclusions: The method of problem analysis and matrix sorting makes it clear how different factors affect the patient’s findings. Only by implementing the government’s promise better, strengthening the self-construction of the prevention and control institutions, carrying out the screening work of the high-risk groups on a regular basis and stepping up the centralized management, can we effectively improve the level of patient discovery.