Effect of tuberculosis control before and after implementation of designated hospital service-a case study of six model regions

Objective To analyze changes in effects of tuberculosis (TB) detection and treatment before and after the implementation of government administration-designated hospital service model and to provide references for smooth development of the new service model.Methods Data on TB registration two years before and 3-5 years after the implementation of designated hospital service in six model regions of three provinces were collected in November 2015 to analyze changes in TB registration rate,the registration rate of smear-positive TB,the cure rate of smear-positive TB and treatment completion rate of smear-negative TB.Results The TB registration rate increased from 59.05/100 000 and 54.58/100 000 two years before the implementation to 80.51/100 000 and 72.4/100 000 three years after the implementation of the new service model in Liuyang municipality of Hunan province and Yanliang district of Shaanxi province;whereas the rate declined significantly in the other four model regions,especially in Qingyun county of Shandong province (from 64/100 000 to 13.16/100 000 during the same period).The registration rate of smear-positive TB decreased in all model regions studied;while the completion treatment rate of both smear-positive and smear-negative TB showed no statistically significant variation.Conclusion After the implementation of designated hospital service,the quality of TB detection and registration were improved only in some model regions but declined in most model regions;while the effect of TB treatment met the requirement of national TB control planning.The study results suggest that management on TB registration should be strengthened after the implementation of designated hospital service to TB patients.