Effectiveness evaluation of hierarchical diagnosis model for multidrug-resistant tuberculosis from 2015 to 2017 in Zigong City

doi:10.3969/j.issn.1000-6621.2018.12.020

Abstract

Abstract:

Objective To evaluate the effectiveness of hierarchical diagnosis model for multidrug-resistant tuberculosis (MDR-TB) from 2015 to 2017 in Zigong City.Methods The patients’ routine registration and report records in Ziliujing district, Daan district, Yantan district, Fushun county, Rong county and Gongjing district from 2015 to 2017 were collected. All of 4418 patients were registered in designated Centers for disease control and prevention (CDC)-hospital mixed institutions (Ziliujing district, Daan district and Yantan district). 4922 patients were registered in designated district/county hospitals (Fushun county, Rong county and Gongjing district). The detection, diagnosis, management, and economic expenses of MDR-TB patients were analyzed.Results In the model of designated CDC-hospital mixed institutions and designated district/county hospitals, the MDR-TB detection rate in tuberculosis were 9.2% (54/587) and 5.4% (37/684), the proportion of traditional drug susceptibility testing among sputum culture positive patients were 93.9% (460/490) and 84.1% (402/478), and the treatment rate of MDR-TB patients were 13.0% (7/54) and 59.5% (22/37); differences were all significant (χ ² value were 6.83, 23.72 and 21.86, respectively, all P values were <0.05). The treatment success rate were 5/7 and 77.3% (17/22), respectively, and the difference was not statistically significant (χ ²=0.10, P>0.05). The average direct economic burden per capita were (28006.90±2.83) and (26395.70±5.15) yuan, among which out-of-pocket hospitalization expenses (being reimbursed 70%) accounted for 41.8% (11696.53/28006.90) and 40.6% (10719.40/26395.70), respectively. Conclusion Despite the generally satisfactory effectiveness of hierarchical diagnosis model for MDR-TB in Zigong City, the management of referral and tracking in place, treatment rate, and healthcare payment pattern are recommended to be improved further.

Key words: Tuberculosis, multidrug-resistant, Physician’s practice patterns;, Progressive patient care, Cost of illness, Outcome and process assessment (health care)

NING Zhu,YANG Lin,SHI Wen-pei,XIE Yan,CAO Hong,ZHANG Zheng-dong,HU Yi,XU Biao. Effectiveness evaluation of hierarchical diagnosis model for multidrug-resistant tuberculosis from 2015 to 2017 in Zigong City[J]. Chinese Journal of Antituberculosis, 2018, 40(12): 1346-1349. doi: 10.3969/j.issn.1000-6621.2018.12.020

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