[Access to tuberculosis care among community patients with chronic cough in Yangzhong County, Jiangsu Province].
OBJECTIVE
To describe the access to tuberculosis care among patients with long-term chronic cough (potential TB cases), and to study the impact of socio-economic and demographic factors on the access.


METHODS
Randomized cluster sampling was used to select 20 villages as the study sites from 94 villages in a county where modern TB control program with DOTS has not been established--Yangzhong in Jiangsu Province, China. 171 patients with chronic cough, identified from all residents (n=33549) aged >14 years were interviewed using a structured questionnaire. Fluoroscopy and sputum smear were used for diagnosis.


RESULTS
The median delay of patients (n=56) who did not seek any health care (quartile: 51 days-93 days) was 67 days, longer than the delay to first health care provider (10 days, quartile: 4 days-31 days) and patient's delay (15 days, quartile: 5-31 days) of those who had sought health care (P = 0.000). Uninsured patients were 42.2% less likely to access health facility and general hospitals than insured patients; meanwhile, they had a longer delay to first health care provider and general hospital. Men were less likely to seek health care service in primary health care provider. Farmers had a longer delay to first health care provider, so did the patients whose houses were far from health facilities.


CONCLUSIONS
Potential TB patients with long-term cough in the non-program area of China have poor access to tuberculosis care,which could affect the detection of TB patients in population. Medical insurance is one of the most important factors to influence patients' access to TB care.
Fei
Yang
Y
School of Public Health, Fudan University, Shanghai 200032, China.
Wang
Jian-ming
JM
Zhang
Ji-hong
JH
Gu
Qi-hua
QH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003371:Cough / Q000175:diagnosis / Q000209:etiology*; D057210:Delayed Diagnosis; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D019035:Rural Health Services; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000517:prevention & control; D055815:Young Adult