The Establishment And Impact Analysis Of A New Case Management System

Objective To evaluate the feasibility and acceptability of a new case management system to help county TB staff identify treatment interrupters and take remedial action. And to make political suggestions on a new case management system to improve the smear-positive pulmonary tuberculosis patients'adherence.Contents To describe the intervention which was piloted in two counties of Chongqing municipality; used data collected in the new management information system (forms 1 and 2) to describe the number and type of remedial actions carried out, reasons for interrupting treatment, and to estimate completion rate; problems encountered during implementation; and TB programmed staff views on the acceptability of the intervention.Methods EXCEL and SPSS were used to analyze quantitative data, while Thematic Framework Analysis was used to analyze the qualitative data.Results Patients management team which in charge of the intervention implementation was separately established in two counties of Chongqing. The information officer found out the interrupters through the patients record, and took remedial action to get patients back onto treatment. The quantitative results found that the new case management had improved the patients'adherence. In RC county, the township and village doctors were involved in the intervention. And collaborative team work helped intervention implementation there. Patients gave various reasons for treatment interruption and these have implications for patient management. And deeper research should consider the migration TB patients as our study didn't have any intervention focused on those going out for work.Conclusion Remedial action may only prove feasible in other counties in China if considered in the context of government commitment to case management, including improved payment mechanisms for village and township doctors.