Survey on health service utilization status and needs of 445 pulmonary tuberculosis patients in the Chongqing metropolitan area

Zhang Ting; Fan Jun; Wu Chengguo; Pang Yan; Li Ting; Liu Hui; Zhang Jun; He Yue; Zhou Hailong; Zhang Lei; Tang Xiaoli; Yi Benju; He Yunyun

doi:10.11986/j.issn.1673-873X.2025.06.02

Abstract：Objective To analyze the health service utilization status and service needs of pulmonary tuberculosis(TB)pa-tients in the Chongqing metropolitan area,and to provide theoretical evidence for integrated TB prevention and control in the Chongqing metropolitan area.Methods Six counties/districts across Guang'an City in Sichuan Province(hereinafter re-ferred to as"Guang'an area")and six districts adjacent to Guang'an in Chongqing(Yubei,Jiangbei,Beibei,Hechuan,Tongnan,and Changshou,hereinafter referred to as"Chongqing area")were selected for this study.Pulmonary TB patients registered in designated TB medical institutions in the study areas in 2023 were enrolled as the study participants.A self-de-signed questionnaire was used to collect data on patients' current utilization of health services and needs during TB consulta-tion,treatment,and health management;chi-square tests and other methods were used for univariate analysis.Results Af-ter the onset of suspected pulmonary TB symptoms and before their first medical visit,61.57％of respondents chose to buy symptomatic medication at a pharmacy,and 39.43％did nothing;respondents' first-visit institutions were mainly general medical institutions,while diagnostic confirmation was mainly made at designated TB medical institutions.There was a sta-tistically significant difference between the Guang'an area and the Chongqing area in the type of institution where diagnosis was confirmed(P＜0.05).In the past two weeks,the proportions of respondents who had missed doses,stopped medica-tion when symptoms were controlled,or forgotten to bring medication when going out were 15.28％,6.07％,and 14.16％,respectively.A total of 79.55％of respondents received health management mainly from primary-level medical and health institution personnel;48.54％reported that supervised medication was primarily conducted by a combination of home visits and telephone follow-up;70.34％preferred self-administered medication at home as their treatment management mode.Differences between the Guang'an area and the Chongqing area in the type of health-management personnel and the methods of supervised medication were statistically significant(P＜0.05).Conclusion Authorities in Sichuan and Chongqing should attach importance to patients' needs for TB prevention and care services.Healthcare personnel should in-tegrate health education into the entire TB diagnosis,treatment,and follow-up management process,especially at the initial stages of treatment and management;identify high-risk groups for missed doses and treatment interruption based on pa-tients' circumstances and negotiate individualized interventions with patients;and strengthen TB prevention and control ca-pacity among primary healthcare staff.