The Quality of Tuberculosis Care in Urban Migrant Clinics in China

Hao Xue, Jennifer Hager, Qi An, Kai Liu, Jing Zhang, Emma Auden, Bingyan Yang, Jie Yang, Hongyan Liu, Jingchun Nie, Aiqin Wang, Chengchao Zhou, Yaojiang Shi and Sean Sylvia
Additional contact information
Hao Xue: School of Economics and Management, Northwest University, Xi’an 710069, China
Jennifer Hager: Department of Health, Sport, and Exercise Sciences, School of Education, University of Kansas, Lawrence, KS 66045, USA
Qi An: Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
Kai Liu: Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
Jing Zhang: Faculty of Liberal Arts, Northwest University, Xi’an 710069, China
Emma Auden: Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
Bingyan Yang: School of Economics and Management, Wuhan University, Wuhan 430072, China
Jie Yang: Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
Hongyan Liu: School of Economics, Northwest University of Political Science and Law, Xi’an 710122, China
Jingchun Nie: Center for Experimental Economics in Education, Shaanxi Normal University, Xi’an 710127, China
Aiqin Wang: School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China
Chengchao Zhou: Institute of Social Medicine and Health Administration, School of Public Health, Shandong University, Jinan 250012, China

IJERPH, 2018, vol. 15, issue 9, 1-15

Abstract: 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

Keywords: standardized patients; quality of tuberculosis care; rural-to-urban migrants; migrant clinics (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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