X-L Wei1, X-Y Liang, J D Walley, F-Y Liu, B-Q Dong. 1. Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK. xiaolin.wei@utoronto.ca
Abstract
SETTING: Tuberculosis (TB) care has been decentralised to township hospitals in a rural, poor area of Guangxi, China, since 1 April 2005. Routine county-based TB care was provided in a comparable control area. OBJECTIVE: To compare patients' care-seeking behaviours between the intervention and control groups. METHODS: In February 2007, all 230 new pulmonary TB smear-positive patients registered in the intervention and control groups between 1 April 2005 and 31 July 2006 were approached; of these, 171 were surveyed using a structured questionnaire. Their patient records were reviewed to minimise recall bias. RESULTS: Patients in the intervention group spent less for treating TB symptoms prior to TB diagnosis compared with the control group (P < 0.01). Travel costs were lower in the intervention than control group, but the difference was not statistically significant (P > 0.05). Diagnostic delays for patients in the intervention and control groups were respectively 26 and 38 days (t = -0.835, P> 0.05). Logistic regression suggested that visiting county general hospitals tended to prolong patient diagnostic delay and cost more before TB diagnosis. CONCLUSION: Decentralising TB services to township hospitals brought TB care closer to rural patients, shortened TB patient care-seeking pathways and reduced costs before TB diagnosis.
SETTING:Tuberculosis (TB) care has been decentralised to township hospitals in a rural, poor area of Guangxi, China, since 1 April 2005. Routine county-based TB care was provided in a comparable control area. OBJECTIVE: To compare patients' care-seeking behaviours between the intervention and control groups. METHODS: In February 2007, all 230 new pulmonary TB smear-positive patients registered in the intervention and control groups between 1 April 2005 and 31 July 2006 were approached; of these, 171 were surveyed using a structured questionnaire. Their patient records were reviewed to minimise recall bias. RESULTS:Patients in the intervention group spent less for treating TB symptoms prior to TB diagnosis compared with the control group (P < 0.01). Travel costs were lower in the intervention than control group, but the difference was not statistically significant (P > 0.05). Diagnostic delays for patients in the intervention and control groups were respectively 26 and 38 days (t = -0.835, P> 0.05). Logistic regression suggested that visiting county general hospitals tended to prolong patient diagnostic delay and cost more before TB diagnosis. CONCLUSION: Decentralising TB services to township hospitals brought TB care closer to rural patients, shortened TB patient care-seeking pathways and reduced costs before TB diagnosis.
Authors: Y Lin; D A Enarson; C-Y Chiang; I D Rusen; L-X Qiu; X-H Kan; Y-L Yuan; J Du; T-H Zhang; Y Li; X-F Li; C-T Du; L-X Zhang Journal: Public Health Action Date: 2015-03-21
Authors: Ibrahim Sendagire; Maarten Schim Van der Loeff; Mesach Mubiru; Joseph Konde-Lule; Frank Cobelens Journal: PLoS One Date: 2010-12-29 Impact factor: 3.240
Authors: Xiaolin Wei; Guanyang Zou; Hui Zhang; Renzhong Li; John D Walley; Shiwen Jiang; Jia Yin; Shuigao Jin; You Li; Qiang Sun; James N Newell; Sian Griffiths; Lixia Wang Journal: BMC Public Health Date: 2011-02-15 Impact factor: 3.295