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Open AccessArticle

The Quality of Tuberculosis Care in Urban Migrant Clinics in China

1
School of Economics and Management, Northwest University, Xi’an 710069, China
2
Department of Health, Sport, and Exercise Sciences, School of Education, University of Kansas, Lawrence, KS 66045, USA
3
Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
4
Faculty of Liberal Arts, Northwest University, Xi’an 710069, China
5
Rural Education Action Program, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA
6
School of Economics and Management, Wuhan University, Wuhan 430072, China
7
School of Economics, Northwest University of Political Science and Law, Xi’an 710122, China
8
School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China
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Institute of Social Medicine and Health Administration, School of Public Health, Shandong University, Jinan 250012, China
10
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(9), 2037; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15092037
Received: 9 August 2018 / Revised: 11 September 2018 / Accepted: 13 September 2018 / Published: 18 September 2018
(This article belongs to the Special Issue Poverty, Inequality and Public Health in China)
Large and increasing numbers of rural-to-urban migrants provided new challenges for tuberculosis control in large cities in China and increased the need for high quality tuberculosis care delivered by clinics in urban migrant communities. Based on a household survey in migrant communities, we selected and separated clinics into those that mainly serve migrants and those that mainly serve local residents. Using standardized patients, this study provided an objective comparison of the quality of tuberculosis care delivered by both types of clinics and examined factors related to quality care. Only 27% (95% confidence interval (CI) 14–46) of cases were correctly managed in migrant clinics, which is significantly worse than it in local clinics (50%, 95% CI 28–72). Clinicians with a base salary were 41 percentage points more likely to demonstrate better case management. Furthermore, clinicians with upper secondary or higher education level charged 20 RMB lower out of pocket fees than less-educated clinicians. In conclusion, the quality of tuberculosis care accessed by migrants was very poor and policies to improve the quality should be prioritized in current health reforms. Providing a base salary was a possible way to improve quality of care and increasing the education attainment of urban community clinicians might reduce the heavy barrier of medical expenses for migrants View Full-Text
Keywords: standardized patients; quality of tuberculosis care; rural-to-urban migrants; migrant clinics standardized patients; quality of tuberculosis care; rural-to-urban migrants; migrant clinics
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MDPI and ACS Style

Xue, H.; Hager, J.; An, Q.; Liu, K.; Zhang, J.; Auden, E.; Yang, B.; Yang, J.; Liu, H.; Nie, J.; Wang, A.; Zhou, C.; Shi, Y.; Sylvia, S. The Quality of Tuberculosis Care in Urban Migrant Clinics in China. Int. J. Environ. Res. Public Health 2018, 15, 2037. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15092037

AMA Style

Xue H, Hager J, An Q, Liu K, Zhang J, Auden E, Yang B, Yang J, Liu H, Nie J, Wang A, Zhou C, Shi Y, Sylvia S. The Quality of Tuberculosis Care in Urban Migrant Clinics in China. International Journal of Environmental Research and Public Health. 2018; 15(9):2037. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15092037

Chicago/Turabian Style

Xue, Hao; Hager, Jennifer; An, Qi; Liu, Kai; Zhang, Jing; Auden, Emma; Yang, Bingyan; Yang, Jie; Liu, Hongyan; Nie, Jingchun; Wang, Aiqin; Zhou, Chengchao; Shi, Yaojiang; Sylvia, Sean. 2018. "The Quality of Tuberculosis Care in Urban Migrant Clinics in China" Int. J. Environ. Res. Public Health 15, no. 9: 2037. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15092037

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