Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Institute of Model Animals of Wuhan University, Wuhan, 430072, China.
BMC Infect Dis. 2020 Jul 11;20(1):501. doi: 10.1186/s12879-020-05235-9.
Tuberculosis (TB) still causes high economic burden on patients in China, especially for rural patients. Our study aims to explore the risk factors associated with the high costs for TB inpatients in rural China from the aspects of inpatients' socio-demographic and institutional attributes.
Generalized linear models were utilized to investigate the factors associated with TB inpatients' total costs and out-of-pocket (OOP) expenditures. Quantile regression (QR) models were applied to explore the effect of each factor across the different costs range and identify the risk factors of high costs.
TB inpatients with long length of stay and who receive hospitalization services cross provincially, in tertiary and specialized hospitals were likely to face high total costs and OOP expenditures. QR models showed that high total costs occurred in Dingyuan and Funan Counties, but they were not accompanied by high OOP expenditures.
Early diagnosis, standard treatment and control of drug-resistant TB are still awaiting for more efforts from the government. TB inpatients should obtain medical services from appropriate hospitals. The diagnosis and treatment process of TB should be standardized across all designated medical institutions. Furthermore, the reimbursement policy for migrant workers who suffered from TB should be ameliorated.
结核病（TB）仍然给中国的患者带来了沉重的经济负担，尤其是农村患者。本研究旨在从住院患者的社会人口学和机构属性方面探讨与中国农村地区结核病住院患者高费用相关的因素。
利用广义线性模型探讨与结核病住院患者总费用和自付费用（OOP）相关的因素。利用分位数回归（QR）模型探讨每个因素在不同费用范围内的影响，并确定高费用的风险因素。
住院时间长且跨省级、在三级和专科医院接受住院服务的结核病住院患者可能面临高总费用和 OOP 支出。QR 模型显示，定远县和阜南县的总费用较高，但 OOP 支出并不高。
政府仍需努力实现早期诊断、标准治疗和耐药结核病的控制。结核病住院患者应从适当的医院获得医疗服务。应规范所有指定医疗机构的结核病诊断和治疗流程。此外，应改善农民工因结核病而遭受的报销政策。
