Analysis of care-seeking pathways of tuberculosis patients in Guangxi, China, with and without decentralised tuberculosis services
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.
Document Type: Regular Paper
Affiliations: 1: Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK 2: Guangxi Provincial Health Bureau, Guangxi, China 3: Guangxi Centre for Disease Control and Prevention, Guangxi, China
Publication date: 01 April 2009
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