Study On The Implementation Status Of TB Control Model Of Designated Hospitals In Chongqing

Objectives:To investigate the current situation of tuberculosis(TB) prevention and control work under the designated hospital mode in Chongqing in 2013, evaluate the designated hospital mode by treatment delayed、delayed diagnosis、treatment denouement、disease burden and management, and providing scientific basis for the implementation of TB control mode according to the actual situation in Chongqing.Methods:Choose 2 counties from the counties that carried out designated hospital mode as designated hospital group. Choose 2 counties from the counties that carried out CDC mode as CDC group. Investigating the 2 groups patients by questionnaires and records during all the treatment in 2013. EPI Data 3.1 was used double entry checked data and SPSS 19.0 was used analyzed the data.Results:617 cases in designated hospital group and612 cases in CDC group. Men was more than women;The educational background of more people was secondary education and below and a higher proportion of medical insurance; most patients first diagnosed was non-professional organizations; 185(29.98%)cases in designated hospital group were treatment delay and 283(46.24%)cases in CDC group. Treatment delay rate in designated hospital group was lower than in CDC group(P<0.05), Logistic regression analysis found that which was little income was more likely to appear treatment delay in designated hospital group; which was no physical signs was more likely to appear treatment delay in CDC group. In diagnosis delay rate designated hospital group was higher than CDC group(P<0.05), Logistic regression analysis found that which was more income、not floating population、higher educational background were likely to appear diagnosis delay in designated hospital group; which was no physical signs was more likely to appear diagnosis treatment delay in CDC group. Designated hospital group was lower than CDC group in first-line standard chemotherapy drugs rate(P<0.05). Designated hospital group’s direct medical costs was more than CDC group(P< 0.05). Tracking rate and overall arriving rate、sputum smear-negative rate after 2 months、successful treatment rate cure rate in patients with smear-positive、Completion of treatment in patients with smear-negative rate, designated hospital group was higher than CDC group. The average direct medical expenses was higher after diagnosis. Designated hospital in referral rate was lower than CDC group. Internal referral was low in designated hospital.Conclusion:Designated hospital group had an advantage over CDC group, such as shorten treatment delay、better treatment denouement, and was able to accomplish the work. Designated hospital mode was well implemented, and had a good prospects for promotion. But there was problem, so TB control mode was selected according to local conditions to carry out TB prevention and control work, to control TB epidemic effectively.