Survey of tuberculosis hospitals in China: current status and challenges.
Survey of tuberculosis hospitals in China: current status and challenges.
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DOI：
10.1371/journal.pone.0111945
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Li L
中科院分区：
文献类型：
--
作者：
Du J;Pang Y;Liu Y;Mi F;Xu S;Li L
在中国，医院将在结核病治疗服务中发挥越来越重要的作用，但目前对结核病治疗医院系统的情况知之甚少。为了了解结核病医院的现状，我们对来自31个省和新疆生产建设兵团的203家结核病医院进行了调查。在203家医院中，93家（45.8%）位于中国东部地区，84家（41.4%）位于中部地区，26家（12.8%）位于西部地区，而中国西部地区有3460万结核病患者，占全国结核病负担的34.6%。这203家医院的工作人员总数为83 011人，其中18 899人（22.8%）为结核病患者提供保健服务（医生、护士、实验室技术人员等）。1999 - 2009年203所医院的医务人员和结核病防治人员的总体数量均有所增加，但医务人员增加了52%，结核病防治人员仅增加了34%，结核病防治人员的比例明显下降（χ2 = 181.7，P<0.01）。 从1999年到2009年，203家医院的年总收入增加了5.5倍，而同期结核病护理收入增加了3.8倍。在此期间，结核病护理和控制经历了相对较慢的发展，表现为结核病工作人员的百分比较低，医院结核病护理收入的增长较少。总之，我们的研究结果表明，中国西部地区的医院资源比东部地区更稀缺。鉴于目前的调查结果，敦促决策者解决不发达的西部和较富裕的东部省份之间医疗资源分配不均的问题。
Hospitals will play an increasingly important role in delivering TB services in China, however little is known in terms of the current landscape of the hospital system that delivers TB care. In order to examine the status of TB hospitals we performed a study in which a total of 203 TB hospitals, with 30 beds or more, were enrolled from 31 provinces and Xinjiang Production and Construction Corps. Of the 203 hospitals, 93 (45.8%) were located in the eastern region of China, 84 (41.4%) in the central region, and 26 (12.8%) in the western region, while there were 34.6 million TB patients in western China, accounting for 34.6% of the TB burden nationwide. The total number of staff in these 203 hospitals was 83,011, of which 18,899 (22.8%) provided health services for TB patients, (physicians, nurses, lab technicians, etc). Although both the overall number of the health care workers and TB staff in the 203 hospitals increased from the year 1999 to 2009, the former increased by 52%, while the latter increased only by 34%, showing that the percentage of TB staff declined significantly (χ2 = 181.7, P<0.01). The total annual income of the 203 hospitals increased 5.5 fold from 1999 to 2009, while that from TB care increased 3.8 fold during the same period. TB care and control experienced a relatively slower development during this period as shown by the lower percentage of TB staff and the lesser increase in income from TB care in the hospitals. In conclusion, our findings demonstrated that hospital resources are scarcer in western China as compared with eastern China. In view of the current findings, policymakers are urged to address the uneven distribution of medical resources between the underdeveloped west and the more affluent eastern provinces.
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