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Source: http://journals.plos.org/plosmedicin...l.pmed.1002405
Tuberculosis detection and the challenges of integrated care in rural China: A cross-sectional standardized patient study
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Background Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China?s health system?characterized by a movement toward ?integrated care? and promotion of initial contact with grassroots providers?will affect the care of TB patients...
...Conclusions There were significant quality deficits among village clinics and township health centers in the management of a classic case of presumptive TB, with higher proportions of correct case management in county hospitals. Poor clinical performance does not arise only from a lack of knowledge, a phenomenon known as the ?know-do? gap. Given significant deficits in quality of care, reforms encouraging first contact with lower tiers of the health system can improve efficiency only with concomitant improvements in appropriate management of presumptive TB patients in village clinics and township health centers...
Tuberculosis detection and the challenges of integrated care in rural China: A cross-sectional standardized patient study
- Sean Sylvia,
- Hao Xue,
- Chengchao Zhou,
- Yaojiang Shi,
- Hongmei Yi,
- Huan Zhou,
- Scott Rozelle,
- Madhukar Pai,
- Jishnu Das
x- Published: October 17, 2017
- https://doi.org/10.1371/journal.pmed.1002405
Background Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China?s health system?characterized by a movement toward ?integrated care? and promotion of initial contact with grassroots providers?will affect the care of TB patients...
...Conclusions There were significant quality deficits among village clinics and township health centers in the management of a classic case of presumptive TB, with higher proportions of correct case management in county hospitals. Poor clinical performance does not arise only from a lack of knowledge, a phenomenon known as the ?know-do? gap. Given significant deficits in quality of care, reforms encouraging first contact with lower tiers of the health system can improve efficiency only with concomitant improvements in appropriate management of presumptive TB patients in village clinics and township health centers...