Influence of Public Health Services on the Goal of Ending Tuberculosis: Evidence From Panel Data in China.

Yang Chen,Zhaohui Gong,Chao Hao,Zhaoyang Zhang,Qunhong Shen,Lingzhong Xu,Zhi Hu,Mo Hao,Hua Wang,Zheng Chen,Chengyue Li,Xinmei Yang,Panshi Wang,Tianqiang Xu,Peiwu Shi,Anning Ma,Qingyu Zhou,Chuan Pu

doi:10.3389/fpubh.2022.826800

Abstract

BackgroundThe World Health Organization has proposed an initiative to “end tuberculosis (TB).” Unfortunately, TB continues to endanger the health of people worldwide. We investigated the impact of public health services (PHS) in China on TB incidence. In this way, we provided policy ideas for preventing the TB epidemic.MethodsWe used the “New Public Management Theory” to develop two indicators to quantify policy documents: multisector participation (MP) and the Assessable Public Health Service Coverage Rate (ASCR). The panel data from 31 provinces in Chinese mainland were collected from 2005 to 2019 based on 1,129 policy documents and the China Statistical Yearbook. A fixed-effect model was used to determine the impact of MP and the ASCR on TB incidence.ResultsFrom 2005 to 2019, the average MP increased from 89.25 to 97.70%, and the average ASCR increased from 53.97 to 78.40% in Chinese mainland. However, the development of ASCR between regions was not balanced, and the average level in the western region was lower than that in the eastern coastal provinces. With an increase in MP and the ASCR, the TB incidence had been decreasing gradually in recent years. The panel analysis results showed that MP (β = −0.76, p < 0.05). and ASCR (β = −0.40, p < 0.01) had a negative effect on TB incidence, respectively. Even if the control variables were added, the negative effects of MP (β = −0.86, p < 0.05) and ASCR (β = −0.35, p < 0.01) were still statistically significant.ConclusionsPromoting the participation of multiple departments, as well as emphasizing the quality of PHS delivery, are important ways to alleviate the TB epidemic. The settings of evaluation indices for PHS provision should be strengthened in the future.

Highlights

The World Health Organization has proposed an initiative to “end tuberculosis (TB).” TB continues to endanger the health of people worldwide
From 2005 to 2019, the Assessable Healthcare Service Coverage Rate (ASCR) increased from 53.97 to 78.40%, which indicated that the provinces had established TB-control programs actively and strengthened evaluation of public health services (PHS) based on World Health Organization (WHO) and national initiatives
Shanghai, Zhejiang, Jiangsu, and Hainan had set evaluation indices for all PHS categories, which were accompanied by the highest ASCR

Summary

Introduction

The World Health Organization has proposed an initiative to “end tuberculosis (TB).” TB continues to endanger the health of people worldwide. We investigated the impact of public health services (PHS) in China on TB incidence. In this way, we provided policy ideas for preventing the TB epidemic. The World Health Organization (WHO) proposed a program to eradicate TB by 2035, implying that the incidence rate and mortality rate of TB would be reduced by 90 and 95%, respectively, by 2035 compared with those in 2015 [3]. A growing body of research has indicated that providing adequate, high-quality, and accessible public health services (PHS) for TB would help to alleviate the TB epidemic [4]. Improving the utilization rate of PHS for TB could reduce the incidence and mortality in high-risk populations [8]. The WHO recommended that countries should take systematic and robust action to increase access to TB-prevention services and other preventive projects [11]

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Results

Discussion

Conclusion