OBJECTIVE: Hospitals provide clinical care to many tuberculosis (TB) patients, but limited linkage with public health programmes is contributing to low TB case detection and rising TB drug resistance. We evaluated a hospital-public health collaboration to improve the follow-up of TB patients initially seen in hospitals. DESIGN: In nine counties in eastern China, we evaluated a collaboration with three interventions: hospitals carried out internet-based reporting and patient referral to the local Center for Disease Control (CDC). The CDC regularly checked on hospital reporting and referrals and performed active follow-up of reported patients, and a government coordinating group facilitated implementation of collaborative activities. RESULTS: Compared to the pre-intervention period, the percentage of TB suspects and patients needing referral from the hospitals who arrived in the CDC increased from 59.3% to 83.2% (P < 0.001). This increase was a result of improved hospital reporting (42.5% to 95.3%, P < 0.001), improved referral from hospitals (48.1% to 83.3%, P < 0.001), active CDC follow-up of 82.5% of reported patients who did not attend CDC by themselves, and successful tracing of 60.8% of these patients. This contributed to a 33% increase in reported smear-positive pulmonary TB cases. CONCLUSION: This model collaboration successfully improved the follow-up of TB patients seen by hospitals, and contributed to an increase in TB case detection. © 2009 The Union.