Xu B, Fochsen G, Xiu Y, Thorson A, Kemp J R, Jiang Q W
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Health Policy. 2004 Aug;69(2):139-49. doi: 10.1016/j.healthpol.2003.11.006.
This study aims to obtain an in-depth understanding of factors that influence the health seeking behavior of TB patients, and access to tuberculosis (TB) care in counties with or without National TB Control Program (NTP) in rural China. Sixteen focus group discussions (FGDs) composed of TB patients and health care providers were held. Content analysis showed perceptions that financial difficulties influence health care-seeking behavior of TB patients in both program and non-program counties. Female and elderly patients were perceived to be more reluctant to seek health care and to seek care for cough from village health stations rather than general hospitals. Many TB patients said they could not afford the cost of TB care, even where services were subsidized. Fee-for-service incentives of health care providers and their ability to make a correct TB diagnosis were also perceived to influence patient access to TB care. Inappropriate treatment of cough patients was perceived to increase the risk of missing smear-positive diagnoses.
本研究旨在深入了解影响中国农村地区结核病患者就医行为的因素，以及在有或没有国家结核病防治规划（NTP）的县获得结核病治疗的情况。我们组织了16场由结核病患者和医疗服务提供者参加的焦点小组讨论（FGD）。内容分析表明，人们认为经济困难会影响项目县和非项目县结核病患者的就医行为。女性患者和老年患者被认为更不愿意就医，且更倾向于从村卫生站而非综合医院寻求咳嗽治疗。许多结核病患者表示，即使在服务有补贴的情况下，他们也负担不起结核病治疗费用。医疗服务提供者的按服务收费激励措施及其正确诊断结核病的能力也被认为会影响患者获得结核病治疗的机会。人们认为对咳嗽患者的不恰当治疗会增加漏诊涂片阳性病例的风险。
