Survey On Pulmonary Tuberculosis Patiemnt’s Visit Flow Economic Burden In Rural Shandong Province In China

BackgroundTuberculosis(TB) is a serious public health problem, estimated8800000new cases of tuberculosis in the world every year and1700000deaths from tuberculosis. Our country is in low and middle income countries, and our country is one of the22TB high burden countries. The fourth national epidemiological survey of tuberculosis show that there are6000000tuberculosis in China, after ranking second in the world, accounting for the total global burden of15%, the prevalence rate is two times more than the city. Rural prevalence accounted for more than80%of the total number of all TB patients. In our country every year250000people die of tuberculosis, Is the third largest cause of death after AIDS and ischemic heart disease.ObjectivesAccording to the investigation of pulmonary tuberculosis patients in rural Shandong Province, the goal of our study is to analyze the flow direction and disease economic burden of pulmonary tuberculosis patients in the study area and quantify the relationship between the flow direction and disease economic burden of pulmonary tuberculosis patients and risk factors. Consequently, we could find the problems on the current medical security system and make out the solution based on results in this study in order to eliminate the unreasonable flow direction and alleviate the economic burden of disease. MethodsStratified cluster random sampling was used in the study. Specifically,664rural resident patients with tuberculosis were selected in6country-level cities of Changqing district, Ju’nan county, Zhangqiu county, Wendeng county, Yishui county and Rushan county of Shandong province from January1to December31of2011. In our study, we analyzed664pulmonary tuberculosis patients. The study provided the descriptive analysis of the flow direction and disease economic burden of pulmonary tuberculosis patients in rural in the study area. Then we applied univariate analysis to research the risk factors among the flow direction and disease economic burden. Finally the multinomial Logistic regression and Poisson regression were used to explore the influencing factors.Main ResultsOur findings of the study included pulmonary tuberculosis patients in rural had poor education and bad economic situation. The results of univariate analysis suggested that age, education, marriage, occupation and gender were related with the flow direction of the pulmonary tuberculosis patients; Compared with other medical institutions, the multinomial Logistic regression indicated that the older, low education degree and unmarried peasants were more likely go to visit clinic. However, the young, high education degree, married and occupied in government offices and enterprises of pulmonary tuberculosis patients were more likely go to visit higher degree of medical institutions. In this study, we found that first visit institutions, confirmed medical institutions, visiting times and first diagnosis were significantly correlated to the disease of economic burden of pulmonary tuberculosis patients. The analysis of Poisson regression showed that first diagnosed as pulmonary tuberculosis and going to TB institutions were more likely have a lower economic burden of disease than the misdiagnosed as other diseases and going to other medical institutions. Conclusion and RecommendationsWe should enhance the publicity and education of TB and strengthen medical security system in the rural areas in order to guiding to a reasonable flow direction and reducing the disease economic burden.