Department of Tuberculosis, Third Hospital of Zhenjiang City, Zhenjiang, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
Int J Tuberc Lung Dis. 2013 Dec;17(12):1575-80. doi: 10.5588/ijtld.13.0144.
A county in Jiangsu Province, China.
To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden.
In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses.
The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay.
Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.
中国江苏省某县。
从患者角度估算结核病（TB）的诊断和治疗费用，并确定患者经济负担的决定因素。
在一项横断面调查中，我们采访了 316 名 2010 年 1 月至 2011 年 5 月间已完成抗结核治疗的确诊患者。TB 患者的经济负担包括自付费用和生产力损失。
人均总自付费用平均为 3024.0 元人民币（CNY），中位数为 1086 CNY（四分位距[IQR] 480-2456）。自付医疗和非医疗费用的平均值分别为 2565.7 CNY 和 458.3 CNY。患者和家属的生产力损失为 2615.2 CNY（中位数 500，IQR 250-2025）。与自付费用和生产力损失相关的因素包括住院、药物不良反应、护肝药物费用、二线抗结核药物费用和诊断延迟。
尽管中国政府实施了“免费结核病服务政策”，但患者的经济负担仍然沉重。需要采取更多以患者为中心的干预措施，以减轻患者的经济负担。
