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Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study
INTRODUCTION: In the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas....
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390147/ https://www.ncbi.nlm.nih.gov/pubmed/34433597 http://dx.doi.org/10.1136/bmjopen-2020-048449 |
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author | You, Xinyi Gu, Jing Xu, Dong Roman Huang, Shanshan Xue, Hao Hao, Chun Ruan, Yunzhou Sylvia, Sean Liao, Jing Cai, Yiyuan Peng, Liping Wang, Xiaohui Li, Renzhong Li, Jinghua Hao, Yuantao |
author_facet | You, Xinyi Gu, Jing Xu, Dong Roman Huang, Shanshan Xue, Hao Hao, Chun Ruan, Yunzhou Sylvia, Sean Liao, Jing Cai, Yiyuan Peng, Liping Wang, Xiaohui Li, Renzhong Li, Jinghua Hao, Yuantao |
author_sort | You, Xinyi |
collection | PubMed |
description | INTRODUCTION: In the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas. The Healthy China 2030 highlights the gate-keeping role of primary healthcare (PHC). However, the impact of PHC reforms on the future TB burden is unclear. We propose to use mathematical models to project and evaluate the impacts of different gate-keeping policies. METHODS AND ANALYSIS: We will develop a deterministic, population-level, compartmental model to capture the dynamics of TB transmission within adult rural population. The model will incorporate seven main TB statuses, and each compartment will be subdivided by service providers. The parameters involving preference for healthcare seeking will be collected using discrete choice experiment (DCE) method. We will solve the deterministic model numerically over a 20-year (2021–2040) timeframe and predict the TB prevalence, incidence and cumulative new infections under the status quo or various policy scenarios. We will also conduct an analysis following standard protocols to calculate the average cost-effectiveness for each policy scenario relative to the status quo. A numerical calibration analysis against the available published TB prevalence data will be performed using a Bayesian approach. ETHICS AND DISSEMINATION: Most of the data or parameters in the model will be obtained based on secondary data (eg, published literature and an open-access data set). The DCE survey has been reviewed and approved by the Ethics Committee of the School of Public Health, Sun Yat-sen University. The approval number is SYSU [2019]140. Results of the study will be disseminated through peer-reviewed journals, media and conference presentations. |
format | Online Article Text |
id | pubmed-8390147 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-83901472021-08-27 Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study You, Xinyi Gu, Jing Xu, Dong Roman Huang, Shanshan Xue, Hao Hao, Chun Ruan, Yunzhou Sylvia, Sean Liao, Jing Cai, Yiyuan Peng, Liping Wang, Xiaohui Li, Renzhong Li, Jinghua Hao, Yuantao BMJ Open Health Policy INTRODUCTION: In the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas. The Healthy China 2030 highlights the gate-keeping role of primary healthcare (PHC). However, the impact of PHC reforms on the future TB burden is unclear. We propose to use mathematical models to project and evaluate the impacts of different gate-keeping policies. METHODS AND ANALYSIS: We will develop a deterministic, population-level, compartmental model to capture the dynamics of TB transmission within adult rural population. The model will incorporate seven main TB statuses, and each compartment will be subdivided by service providers. The parameters involving preference for healthcare seeking will be collected using discrete choice experiment (DCE) method. We will solve the deterministic model numerically over a 20-year (2021–2040) timeframe and predict the TB prevalence, incidence and cumulative new infections under the status quo or various policy scenarios. We will also conduct an analysis following standard protocols to calculate the average cost-effectiveness for each policy scenario relative to the status quo. A numerical calibration analysis against the available published TB prevalence data will be performed using a Bayesian approach. ETHICS AND DISSEMINATION: Most of the data or parameters in the model will be obtained based on secondary data (eg, published literature and an open-access data set). The DCE survey has been reviewed and approved by the Ethics Committee of the School of Public Health, Sun Yat-sen University. The approval number is SYSU [2019]140. Results of the study will be disseminated through peer-reviewed journals, media and conference presentations. BMJ Publishing Group 2021-08-25 /pmc/articles/PMC8390147/ /pubmed/34433597 http://dx.doi.org/10.1136/bmjopen-2020-048449 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Health Policy You, Xinyi Gu, Jing Xu, Dong Roman Huang, Shanshan Xue, Hao Hao, Chun Ruan, Yunzhou Sylvia, Sean Liao, Jing Cai, Yiyuan Peng, Liping Wang, Xiaohui Li, Renzhong Li, Jinghua Hao, Yuantao Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title | Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title_full | Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title_fullStr | Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title_full_unstemmed | Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title_short | Impact of the gate-keeping policies of China’s primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study |
title_sort | impact of the gate-keeping policies of china’s primary healthcare model on the future burden of tuberculosis in china: a protocol for a mathematical modelling study |
topic | Health Policy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390147/ https://www.ncbi.nlm.nih.gov/pubmed/34433597 http://dx.doi.org/10.1136/bmjopen-2020-048449 |
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