关键词: 结核, 肺/诊断, 结核, 肺/药物疗法, 结核, 抗多种药物性/诊断, 结核, 抗多种药物性/药物疗法

Abstract: Objective The purpose of the study was to understand the status of multidrug-resistant tuberculosis(MDR-TB) diagnosis and treatment in prefecture level designated TB hospitals, to analyze problems existed in the process of MDR-TB diagnosis and treatment. Methods A cross-sectional study was conducted to understand the status of TB service delivery through key informant interview and tuberculosis hospitals investigation, to obtain medical diagnosis and therapy situation through inpatients’ medical records investigation.  Results The proportion of financial input by government in total hospital revenue ranged from 5.0% to 30.2% in five hospitals, among them only one out of five hospitals could carry out drug susceptibility test (DST). During hospitalization periods, the standard chemotherapy rate was only 13.3% for multi-drug resistant tuberculosis patients, the median hospital stay was 26 days, the median hospitalization cost was 10893 Yuan, average daily hospital expenses was 362.2 Yuan. The proportion of out of pockets fee by patient accounted for 59%. Only 6.6% of patients were transferred to TB institutions after hospital discharge.  Conclusions At present, the hospitals received low government financial input, and their diagnosis capacity for MDR-TB is weak. The standard chemotherapy rate of MDR-TB patient is low during patients’ hospitalization. In addition, the high hospitalization expenses are in compared with low reimbursement proportion. Most patients discharging from hospitals do not receive timely referral to local TB institutions.

Key words: tuberculosis,pulmonary/diagnosis, tuberculosis,pulmonary/drugtherapy, tuberculosis,multidrug-resistant/diagnosis, tuberculosis,multidrug-resistant/drug therapy