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首页> 外文期刊>Tropical Medicine and International Health: TM and IH >Patient care pathways under the model of integrating tuberculosis service with general hospitals in China
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Patient care pathways under the model of integrating tuberculosis service with general hospitals in China

机译：结核病服务与中国综合医院一体化模式下的患者护理途径

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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.
机译：目的：在综合模式下报告结核病（TB）患者的护理途径，该模式由综合医院而非结核病诊所提供结核病临床服务，旨在为中国的结核病护理改革提供政策建议。方法：随机选择实施一体化模式的六个县，每个县的50名结核病患者参加问卷调查。结果：在301名参与者中，有82名仅参观了结核病指定医院。一名患者总共拜访了两名医疗人员。外部提供者延迟和内部提供者延迟的中位数分别为1天和0天。自付费用的医疗费用中位数总计为379美元; TB指定医院的TB单位为293美元，其他卫生部门为0美元。 Logistic回归分析表明，比起其他医院（OR = 10.16），首先访问基层医疗机构的患者往往有更长的外部延误（OR = 5.71）。结论：集成模型的前景广阔，因为与药房模型相比，该模型报告的患者通路相对较少，延迟时间较短。但是，集成模型并没有降低患者的自付费用。

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