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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Guanyang Zou, Xiaolin Wei, John D Walley, Jia Yin, Qiang Sun
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-21) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

GZ, XW, JW, QS and JY were involved in conception and design of this project, while GZ, XW, QS and JY were involved with the implementation of the project and analysis and interpretation of the data. GZ and XW have drafted the manuscripts while JW and QS have provided critical comments. All authors read and approved the final manuscript.

Abstract

Background

In the majority of China, the Centre for Disease Control (CDC) at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China.

Methods

This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach.

Results

The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site.

Conclusion

The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key words: TB control, service delivery, integration, hospitals, China.
Zusatzmaterial
Authors’ original file for figure 1
12913_2011_1978_MOESM1_ESM.doc
Authors’ original file for figure 2
12913_2011_1978_MOESM2_ESM.doc
Literatur
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