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| 投稿时间： 2015-02-03 最后修改时间： 2015-03-09 摘要点击次数: 3192 全文下载次数: 1714 |
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| 引用本文：徐鹏, 陈琬莹, 琚腊红,等.我国艾滋病防治定点医疗制度的变迁[J].中国卫生政策研究,2015,8(5):67-72 |
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| 徐鹏, 陈琬莹, 琚腊红, 马丽萍, 吕繁 |
| 中国疾病预防控制中心性病艾滋病预防控制中心 北京 102206 |
| 基金项目:国家自然科学基金(71373008) |
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| | 摘要:目的:梳理我国艾滋病定点医疗制度的发展过程,综合分析主要问题及原因,探讨解决思路.方法:对30个省的184个省市县三级医疗卫生机构中从事艾滋病防治工作五年及以上的领导或专家进行问卷调查,对7省2 432名HIV感染者和病人进行问卷调查.结果:防治人员认为定点医疗制度导致的艾滋病病人手术难和住院难问题突出,严重程度为6.49分,在艾滋病防治十大问题中位列第3;2 367名(97.3%)HIV感染者和病人知道定点医疗制度,1 376人在定点医院就诊过,其中,1 177人认为病情得到了有效治疗,124人认为定点医院的医疗技术有限;55名的手术或住院病人认为非定点医院存在推诿问题.政策分析显示,我国艾滋病定点医疗制度是逐渐发展的,表现出历史阶段性和目标短期性.结论:我国艾滋病定点医疗制度的作用明显,但问题突出.改进现有制度的思路包括:提高定点医院的综合服务能力,健全会诊和转诊机制,协调非定点医院提供技术支援,降低医务人员对艾滋病的歧视和恐惧,减少职业暴露风险,加强医院、疾控和病人的沟通. | |
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关键词:艾滋病 定点医疗制度 变迁 问题 策略
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| Evolution and perfection of the HIV/AIDS designated hospital system in China |
| XU Peng, CHEN Wan-ying, JU La-hong, MA Li-ping, LU Fan |
| National Center for STD/AIDS Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China |
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| | Abstract:Objective: To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods: 184 leaders/experts of three levels of healthcare facilities (provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different questionnaires. Results: According to the staff responses, the issues of surgery and hospitalization are difficult and outstanding for PLWHA due to the current designated hospital system with scores of 6.49 in severity. Of the ten largest problems, ranked third is the need for improved AIDS prevention and control. 2 367 (97.3%) PLWHAs had an awareness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85.5% believed that the illness was effectively treated, while 9.0% thought that the medical technology of the designated hospital was limited; 18.7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-designated hospitals. Policy analysis shows that China's designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion: The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing discrimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhancing the communication among hospitals, CDCs and patients. | |
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