摘要
目的 研究SARS疫情解除后北京市发热门诊设置和功能执行上存在的问题 ,提出合理的设置模式。方法 采用定量和定性调查相结合的方式。定量调查包括 (1)后SARS时期 18区县各发热门诊设置和运行方式的调查 ,调查对象为北京市所有现存的 63家医院发热门诊的管理人员。(2 )发热门诊就诊的发热患者的整群抽样调查。 (3 )在发热门诊工作的医生的调查。定性调查包括 :北京市发热门诊负责人调查、北京市 18区县分层随机抽取的 2 3家不同级别医院主管领导、发热门诊负责人及发热门诊工作的医生个人或小组访谈和实地考察 ,未设置发热门诊的医院中随机抽取了 2 8家进行了电话调查。结果 SARS疫情解除后 ,这种仍然以集中就诊的方式对一种疾病进行长期常规监测的系统存在如下问题 :(1)监测网覆盖率低。全市 89%的医院和所有的门诊部均未在监测范围内 ,而未设发热门诊的医院和门诊部已逐渐自发的接受发热患者。但无规范化的管理和完善的信息系统支持。 (2 )目前建立的SARS监测信息系统对SARS疫情的监测功能尚可 ,但对发热病例监测的信息准确性、完整性存在明显问题 ,实名制未真正实施。 (3 )多数发热门诊的人力物力投入和就诊病例的数量明显不成比例 ,造成不同程度的医疗资源利用不足 。
ObjectiveTo identify the experiences and lessons learned on ‘fever clinics’ during the severe acute respiratory syndrom e (SARS) epidemic in Beijing and to propose a better model in monitoring SARS to fit the ‘fever clinics’ into current situation. MethodsBoth qualitative and quantitative methods were us ed in data collection and analyses. Quantitative surveys would include (1) the s etting , functions and administration of current 63 ‘fever clinics' in Beijing; (2) survey on patients with fever who had visited ‘fever clinics’ and randoml y selected from the 63 fever clinics; (3)survey on physicians working in the ‘f e ver clinics’. Qualitative studies would include discussion or interview with ad ministrators, physicians working in the ‘fever clinics’ and field studies on 2 3 randomly selected ‘fever clinics’ as well as telephone interview to the staf f working in the hospitals that did not have the ‘fever clinics’. ResultsA couple of significant problems raised during t he study including: (1)low coverage of current surveillance system. 89% of the hospitals were not covered by the surveillance system which reflecting the misju dgment on the patients with fever that they would only attend ‘fever clinics' t o seek for medical help. The fact was that most of the hospitals where ‘fever c linics' had not been set also received patients with fever. (2)information relat ed to patients with fever needs to improve regarding its completeness and accura cy. (3)significant unbalance in daily cost and effectiveness in most of the ‘fe ver clinics' was noticed. Conclusion ‘Fever clinics’ needs to be adjusted to me et the possible SARS epidemic in coming winter and spring. Short-term and long- term suggestions were proposed regarding SARS monitoring through the functions o f ‘fever clinics’ in Beijing.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2003年第11期999-1004,共6页
Chinese Journal of Epidemiology
