Abstract:

Objective: To survey the status of community treatment and management of pulmonary tuberculosis patients, to provide scientific basis for further improving the regular medication rate and getting better treatment outcome. Methods: A retrospective study was conducted in 228 pulmonary tuberculosis patients registered and managed in four designated hospitals from July 1, 2017 to June 30, 2018 and followed up by 25 community health service institutions in Fengtai District, Beijing. The time of start and stop supervision by the community health service institutions, the time of start and stop treatment for patients recorded by designated hospitals, and the subsequent revisit, interruption and adverse drug response recorded by community health service institutions and designated hospitals were collected. The consistency of the above information between the community follow-up record of the community health service institutions and the medical records of the designated hospitals was analyzed. Results: All patients were followed up by the community health service institutions within 3 working days of being notified. The patients were followed up by telephone, and all the supervisors were family members. Of them, 203 cases (89.0%) were successfully treated (60 cases were cured and 143 cases finished the course of treatment). The subsequent revisit rates at the first month and 3-6 months recorded by community health service institutions were 100.0% (228/228), 99.5% (221/222), 99.1% (215/217), 99.1% (209/211) and 100.0% (209/209), respectively and were 96.9% (221/228), 96.4% (214/222), 94.9% (205/216), 95.2% (198/208) and 95.7% (198/207) recorded in the designated hospitals, the differences were statistically significant (Fisher exact probability test, P=0.016, 0.036, 0.004, 0.004 and 0.004, respectively). Nine cases (3.5%) were recorded of drug interruption in community health service institutions and 20 cases (8.3%) were recorded in designated hospitals. The difference was statistically significant (Fisher exact probability test, P=0.014). There were 41 cases (18.0%) recorded of adverse drug response in community health service institutions and 68 (29.8%) cases were recorded in designated hospitals, the difference was statistically significant (χ²=10.400, P=0.001). Of the patients, 70.2% (160/228) received the supervision from the community health service institutions within 5 days after the start of treatment in hospitals, and 76.8% (175/228) of the patients received the supervision service from the community health service institutions within 5 days after the stop of treatment in the designated hospital. Conclusion: The information of subsequent revisit, drug interruption and adverse drug reactions recorded of tuberculosis patients by community health service institutions and designated hospitals were inconsistent. It is necessary to strengthen the informatization and two-way transmission of pulmonary tuberculosis patients’ treatment and supervision management data, as well as the quality control of information input in tuberculosis specialized hospitals and designated hospitals, and patients’ follow-up in community health service institutions.

Key words: Tuberculosis,pulmonary, Case management, Information management, Community health services