持久不坚持结核病患者的拘留
T Oscherwitz1, J P Tulsky, S Roger
1Program in Medical Ethics, University of California, San Francisco, USA.
JAMA
|September 18, 1997
概括
没有接受治疗的结核病患者的民事拘留是一种公共卫生措施. 虽然许多被拘留的患者完成了治疗,但可能需要更长的拘留时间来确保完成治疗.
科学领域:
- 公共卫生 公共卫生
- 传染病控制和控制传染病
- 结核病管理的管理方法
背景情况:
- 持续不坚持结核病 (TB) 治疗构成了严重的公共卫生风险.
- 加利福尼亚州于1993年为非传染性但持续不坚持结核病患者实施了民事拘留程序.
研究的目的:
- 为了识别由结核病控制器监禁的患者特征.
- 确定患者拘留的频率和地点.
- 评估被拘留患者中结核病治疗完成率.
主要方法:
- 一个病例系列设计,与其他成年结核病患者进行横截面比较.
- 1994年在加利福尼亚州12个县进行的研究,结核病例数量很高.
- 数据来源于公共卫生记录,结核病官方采访和官方结核病病例报告.
主要成果:
- 结核病控制人员对67名患者进行了民事拘留或逮捕 (1.3%的符合条件的成年人).
- 被拘留的患者经常经历无家可归 (46%),药物滥用 (81%) 和精神疾病 (28%).
- 在分析的49名被拘留患者中,84%完成了治疗,尽管只有17人被拘留到完成;被拘留患者的随访损失较高,完成率低于非被拘留患者.
结论:
- 改善持续不坚持结核病患者的护理可能需要加强心理社会服务.
- 适当的民事拘留设施对于管理不遵守的个人至关重要.
- 拘留时间应足以确保结核病治疗完成.
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