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Patient care pathways under the model of integrating tuberculosis service with general hospitals in C hina
Author(s) -
Wei Xiaolin,
Yin Jia,
Zou Guanyang,
Walley John,
Zhong Jiemign,
Chen Songhua,
Sun Qiang,
Wang Xiaoming
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12197
Subject(s) - dispensary , medicine , logistic regression , tuberculosis , health care , emergency medicine , medical emergency , family medicine , pathology , economics , economic growth
Objective To report care pathways of tuberculosis ( TB ) patients under the integrated model, where TB clinical service is provided by a general hospital instead of the TB dispensary, with the aim of providing policy recommendations for TB care reforms in C hina. Methods Six counties implementing the integrated model were randomly selected, and 50 TB patients in each county participated in a questionnaire survey. Results Of the 301 participants, 82 visited only the TB designated hospital. A patient visited a median of two health providers in total. The median external provider delay and internal provider delay were 1 and 0 day, respectively. The median out‐of‐pocket medical costs were US $379 in total; US $293 in the TB units and US $0 in other health units in the TB designated hospital. Logistic regression analyses suggested that patients who visited the primary care facilities first tended to have longer external delays ( OR  = 5.71) than patients who visited the other hospitals ( OR  = 10.16). Conclusion The integrated model is promising as it reported relatively fewer patient pathways and shorter delays than the dispensary model. However, the integrated model did not reduce patient out‐of‐pocket costs.

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