[Role of material incentives of medical workers in the early detection and effective treatment of new cases of pulmonary tuberculosis in the Republic of Dagestan].

Abstract

The authors studied the efficiency of material incentives in the amount of 300 rubles for each case to medical workers of the general health care network for early detection and to those of tuberculosis facilities for effective treatment us in 2001-2007. Due to the tuberculosis-controlling measures made in these years with the mechanism of material incentives to medical workers being introduced, the tuberculosis situation stabilized and the major epidemiological indices, such as morbidity, mortality, and prevalence, decreased by 1.3, 2.2, and 1.7 times, respectively. The higher fluorographic coverage of the population and the introduction of microscopy at the general health care facilities resulted in that the number of new cases of fibrocavernous tuberculosis from 5.6 to 0.7% and, on the contrary, the proportion of bacteria-excreting subjected among the new cases of pulmonary tuberculosis increased from 18.4% in 2000 to 45.2% in 2007 or by 2.5 times (p < 0.001). The results of treatment of the new cases became better. Thus, there were increases in the rate of bacterial discharging cessation from 67% in 2000 to 84.5% in 2007 (p < 0.001), that of cavity closure from 59% in 2000 to 75.2% in 2007 (p < 0.001), and that of transfer to diagnostic registration group III from 23.1% in 2000 to 32.4% in 2007 (p < 0.01). Thus, introduction of the material incentives to the medical workers of the general health care network and tuberculosis facilities had a positive impact on the quality of diagnosis and the efficiency of treatment in patients with tuberculosis.