Abstract: Objective To analyze the effects of case based payment for TB outpatient auxiliary diagnosis and treatment on TB patients’ detection and treatment. Methods According to selection criteria of the study site, Miluo county and Linxiang county were selected as the pilot counties, Huarong county as the control county, three counties’ population respectively were 660 000, 502 000 and 729 000 at the end of 2008. Main intervention was case based payment for TB outpatient auxiliary diagnosis and treatment by the new rural cooperative medical scheme (NCMS) in pilot counties. The effect of the pilot on TB case detection and treatment was evaluated through comparison of the consultation rate of TB suspects, case detection rate, the rate of patients delay and the loss-rate of patients before and after the pilot and between pilot and control counties. Description, χ² test and Wilcoxon rank sum test were used for statistical analysis, and the level of test was 0.05. Results The consultation rate of TB suspects in Miluo county was 332.0/100000 during the pilot period which was compared with 209.8/100 000 during the same period last year, increasing by 58.2%, and the difference was statistically significant (χ²=182.852，P<0.001). The consultation rate of TB suspects in Linxiang county was 491.0/100 000 in the pilot period which was compared with 407.2/100 000 last year, increasing by 20.6%, and the difference was statistically significant (χ²=39.921，P<0.001). During the pilot period, 478 and 533 cases of active TB patients were registered in Miluo and Linxiang respectively which corresponded with 416 and 409 cases last year, increasing by 14.9% and 30.3%, respectively. The rate of patients delay in Miluo county was 40.2% during the pilot corresponding with 57.2% last year, decreasing by 29.8%, and the difference was statistically significant (χ²=25.884，P<0.001). The rate of patients delay in Linxiang county was 41.8% during the pilot corresponding with 49.4% last year, decreasing by 15.3%, and the difference was statistically significant (χ²=5.328，P<0.05). The consultation rate of TB suspects in Miluo and Linxiang during the pilot period respectively was 332.0/100 000, 491.0/100 000, while which was 359.0/100 000 in the control county, the differences were statistically significant between Miluo and the control county (χ²=7.253，P<0.01）,and Linxiang and the control county (χ²=127.685，P<0.001）. The rate of patients delay in Miluo and Linxiang county respectively was 40.2%and 41.8%, while which was 48.9% in the control county, and the differences were statistically significant between Miluo and the control county (χ²=7.881，P<0.01), and Linxiang and the control county (χ²=5.443，P<0.05). The case-loss rate of active pulmonary TB patients registered in two pilot counties respectively was 0.2% and 0%, while which was 1.8% in the control county, the differences were statistically significant between Miluo and the control county (χ²=6.283， P<0.05), and Linxiang and the control county (Fisher’s Exact P<0.01). Conclusion Case based payment for outpatient TB auxiliary diagnosis and treatment had improved the case detection level, reduced the number of case-loss and facilitated the standard treatment and management of TB patients.

Key words: Tuberculosis,pulmonary, Ambulatory care, Fees medical