标题：Patient care pathways under the model of integrating tuberculosis service with general hospitals in China
作者机构：[Wei, X] Chinese University of Hong Kong, HK, China, Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Ch 更多
通讯作者地址：[Wang, XM]Zhejiang Ctr Dis Control & Prevent, TB Program, 630 Xincheng Rd, Hangzhou 310051, Zhejiang, Peoples R China.
来源：Tropical Medicine and International Health: TM and IH
关键词：China;Integrated model;Patient care pathways;Tuberculosis
摘要：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 China. 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.