The Study On Hospitalization And Its Determinants Among Pulmonary Tuberculosis Patients In Shandong Province

Background: Tuberculosis (TB) is still the global public health problem, continuing to hinder the socio-economic development of developing countries to some extent and seriously impacting on the health of the poorest populations. China is one of the highest TB burden countries in the world, ranking the second in terms of total number of patients. Detecting and curing the infectious pulmonary tuberculosis patients is the most effective measures in the prevention and control of TB and the whole regular chemotherapy is an important guarantee to improve the level of curing the TB patients. It is of positive significance that tuberculosis prevention and control agencies provide inpatient services, in order to effectively treat tuberculosis patients, as well as improving the successful rate and the cure rate. Therefore the understanding of tuberculosis patients' utilization of inpatient services and its influencing factors is of great realistic significance for improving the strategy of TB control.Objective: To study the present situation of the utilization of inpatient services of pulmonary tuberculosis patients in Shandong Province and its influencing factors, and also find out the existing problems, provide evidence on improving the strategy of TB control.Method: 807 pulmonary TB patients selected from 36 towns in Shandong Province were randomly chosen by using stratified sampling method and interviewed face-to-face by uniformly trained investigators. The data was analyzed with software SPSS 11.0. The indicators such as frequency distribution, proportion of constitution were used in descriptive analysis and the chi-square test and the classification of non-Conditional Logistic Regression, etc. in statistical tests. Research Contents: The main contents including: 1) the demographic characters of family member, such as gender, age, marital status, educational level, occupation and so on; 2) Family economic status, health care costs and medical insurance and so on; 3) the situation of chronic disease within six months before survey; 4) the utilization of inpatient services, the inpatient population, the number of inpatient people; inpatient expense, residential institutions and so on.Main findings 1) The average of direct hospital costs is 5906.59 yuan, accounting for 69.08% of the total household income and 59.45% of the total expenditure; 2) The average of reimbursement to pulmonary tuberculosis patients is 941.54 yuan; 3) The average of indirect hospital costs is 834.68 yuan; 4) 58% of pulmonary tuberculosis patients chose the local TB control institutions for inpatient services, 17.3% the district-level medical institutions, 3.9% township hospitals; 5) Among pulmonary tuberculosis patients in initial treatment, compared to other professional farmers has a low rate of hospitalization; the hospitalization rate of pulmonary tuberculosis patients who are not worried about the pulmonary tuberculosis was significantly lower than that of pulmonary tuberculosis patients has been worried about; 6)Among re-treated pulmonary tuberculosis patients, the hospitalization rate of patients who enjoys a good self-induced health conditions is significantly lower than that of patients who is in a poor self-induced health status.Conclusions and recommendations: 1) To establish and improve the multiple level medical insurance system and also medical aids system, and put TB into the categories of health insurance and medical aids, so as to improve the ability of residents to resist disease risk; 2) To establish and improve the TB publicizing and education net, and carry out actively the health education and health promotion of TB; 3)To establish and carry out pro-poverty health policy, so as to improve the capacity of the utilization of TB health services of the poor; 4)To serve the TB cases including diagnosis and treatment freely.