title: Perceptions and experiences of health care seeking and access to TB care--a qualitative study in rural Jiangsu Province, China.
abstract: 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.
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. bxu@shmu.edu.cn
authors.forename: B
authors.initials: B
authors.lastname: Xu
authors.forename: G
authors.initials: G
authors.lastname: Fochsen
authors.forename: Y
authors.initials: Y
authors.lastname: Xiu
authors.forename: A
authors.initials: A
authors.lastname: Thorson
authors.forename: J R
authors.initials: JR
authors.lastname: Kemp
authors.forename: Q W
authors.initials: QW
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011203:Poverty; D036301:Qualitative Research; D012424:Rural Population; D012737:Sex Factors; D014376:Tuberculosis / Q000188:drug therapy*