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  本文選題：肺結核 + 激勵機制��； 參考：《山西醫(yī)科大學》2012年碩士論文

【摘要】：目的：探究激勵機制在肺結核病二級預防中的作用,為出臺有效激勵政策提供經(jīng)驗和證據(jù)。 方法：本文采用回顧性分析,資料來源于2004年11月至2005年10月山西省50個實施FIDELIS項目(通過為新涂陽肺結核患者提供交通補助促進患者主動求診,進而提高患者發(fā)現(xiàn)、治療管理水平)縣(區(qū))中的4個。收集基線年(無激勵措施)與項目年(有激勵措施)常規(guī)監(jiān)測新涂陽肺結核患者數(shù)據(jù)進行比較,采取分層整群抽樣結防人員、村醫(yī)及村干部、肺結核病患者與可疑者進行問卷調(diào)查,運用相對數(shù)進行描述,行×列表資料對比采用χ2檢驗,通過SPSS11.5軟件完成統(tǒng)計學分析。 結果：①項目年與基線年相比,新涂陽肺結核病患者發(fā)現(xiàn)人數(shù)提高了85.28%,11-5月的7個月內(nèi),基線年統(tǒng)計結果均小于當月項目年的發(fā)現(xiàn)人數(shù),最高的一個月相差86人,最少的也相差7人,提示激勵政策提高了新涂陽肺結核患者的發(fā)現(xiàn)率,對防控工作具有一定效果。②對肺結核患者發(fā)現(xiàn)工作中采取的激勵機制,94.87%結防人員持贊成態(tài)度,98.68%村醫(yī)及村干部持贊成態(tài)度,對肺結核患者的發(fā)現(xiàn)、治療等起到積極作用。③結防人員、村醫(yī)及村干部、肺結核患者與可疑者3類人群對激勵機制中的具體措施有不同看法,但在有獎報病等問題上一致贊同。④在有效調(diào)查的377人中,有76人認為項目年實行的激勵標準較低,有212人認為項目年實行的激勵標準合適,有89人對項目年實行的激勵標準持無所謂態(tài)度。3類人群對激勵標準看法不同,(χ2=103.2,P0.001)。⑤對項目縣實行激勵政策,有78.5%的調(diào)查對象對此政策表示滿意,有21.5%的調(diào)查對象表示不滿意。3類人群對激勵措施滿意度不一。(χ2=14.49,P0.001)。⑥醫(yī)務人員對激勵標準：縣級結防人員對督導管理初治涂陽或重癥涂陰肺結核患者預期補助比國家標準高出60元,村級高出40元；縣級結防人員對督導管理初治涂陰肺結核患者預期補助比國家目前標準高出50元,村級高出40元�？梢姼魅巳簩ξ镔|(zhì)獎勵持較高期望值。 結論：①激勵機制在肺結核病二級預防中起到了積極作用,應該繼續(xù)深入推廣。②對激勵機制實施過程中的一些具體措施,不同人群提出了建設性意見�？梢娫谥贫ㄕ邥r,應該結合實際,權衡利弊,充分發(fā)揮激勵機制的作用。③應該加強項目監(jiān)督管理,合理化辦事程序,使各項措施真正落實到位,提高激勵機制的效益。
[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.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R521

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本文編號：1751770