SETTING: Tuberculosis (TB) care has been decentralised to township hospitals in a rural, poor area of Guangxi, China, since 1 April 2005. Routine county-based TB care was provided in a comparable control area. OBJECTIVE: To compare patients' care-seeking behaviours between the intervention and control groups. METHODS: In February 2007, all 230 new pulmonary TB smear-positive patients registered in the intervention and control groups between 1 April 2005 and 31 July 2006 were approached; of these, 171 were surveyed using a structured questionnaire. Their patient records were reviewed to minimise recall bias. RESULTS: Patients in the intervention group spent less on treating TB symptoms prior to TB diagnosis compared with the control group (P 0.05). Diagnostic delays for patients in the intervention and control groups were respectively 26 and 38 days (t = −0.835, P > 0.05). Logistic regression suggested that visiting county general hospitals tended to prolong patient diagnostic delay and cost more before TB diagnosis. CONCLUSION: Decentralising TB services to township hospitals brought TB care closer to rural patients, shortened TB patient care-seeking pathways and reduced costs before TB diagnosis.
Wei, X.L.; Liang, X.Y.; Walley, J.D.; Liu, F.Y.; Dong, B.Q. Analysis of care-seeking pathways of tuberculosis patients in Guangxi, China, with and without decentralised tuberculosis services. International Journal of Tuberculosis and Lung Disease (2009) 13 (4) 514-520.