Abstract:

Objective: To evaluate the management quality of pulmonary tuberculosis patients in Yongding District, Longyan City, Fujian Province from 2015 to 2025, analyze the influencing factors of treatment success, and provide evidence-based basis for the pilot work of Tuberculosis Patient Care Program. Methods: A retrospective analysis was conducted to collect medical record information of 1382 pulmonary tuberculosis patients registered in the Tuberculosis Management Information System (a subsystem of the China Information System for Disease Control and Prevention) from January 1, 2015 to December 31, 2025, whose current residence was Yongding District, Longyan City, Fujian Province. The patient data were evaluated from four dimensions:diagnostic quality, treatment management quality, follow-up monitoring quality and data quality, as well as treatment outcomes. Results: The overall management quality of pulmonary tuberculosis patients in Yongding District from 2015 to 2025 was acceptable but had obvious shortcomings, with unbalanced management levels across dimensions. In terms of diagnostic quality, the problem of delayed medical consultation was prominent, with a delayed consultation rate of 82.1% (1135/1382). The quality of etiological detection improved year by year, and the etiological positive rate increased from 58.0% (94/162) to 71.7% (71/99) over the decade (r=0.773, P=0.009). Treatment and follow-up management were well implemented. The overall treatment success rate of 1324 patients with valid outcomes was 87.0% (1152/1324), and it increased to 90.9% (90/99) in 2024 after the implementation of the Tuberculosis Patient Care Program pilot. Influencing factor analysis showed that high medication adherence (OR=20.26, 95%CI:6.86-59.85, P<0.001) and first home visit (OR=2.96, 95%CI:1.84-4.76, P<0.001) were independent protective factors for improving treatment success rate. The treatment success rate of dust-exposed population was 75.7% (28/37), lower than 87.3% (1124/1287) of the general population, but the difference was not statistically significant (χ²=3.363, P=0.067). Data management quality was weak, with only 63.7% (880/1382) of patients having complete symptom records, and logical errors such as negative data existed, which restricted the improvement of refined pulmonary tuberculosis management quality. Conclusion: The overall management and treatment effects of pulmonary tuberculosis patients in Yongding District, Longyan City, Fujian Province from 2015 to 2025 were good, and the treatment quality was further improved after the pilot implementation. Grassroots management coverage was extensive, but there were serious delayed medical consultation and weak data quality. Medication adherence and first home visit are key controllable factors affecting patients’ treatment success, which can provide scientific basis for optimizing the management model and implementing precise measures in the local Tuberculosis Patient Care Program pilot.

Key words: Tuberculosis, pulmonary, Treatment outcome, Case management, Factor analysis, statistical