Ding H, Lu P, Ding X Y, Li Z Q, Zhu L M, Liu Q
Department of Chronic Communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Sep 10;45(9):1251-1257. doi: 10.3760/cma.j.cn112338-20240311-00112.
To explore the direct economic burden and factors affecting out-of-pocket direct costs of multidrug-/rifampicin-resistant pulmonary tuberculosis (MDR/RR-PTB) patients in Jiangsu Province. MDR/RR-PTB patients diagnosed and treated at 13 municipal tuberculosis (TB)-designated hospitals in Jiangsu Province between January 1, 2021, and December 31, 2022, were included, and basic information and direct economic costs were obtained through questionnaires and hospital information systems. Stepwise multiple linear regression was used to analyze the factors influencing patients' out-of-pocket direct costs. The age of the 233 MDR/RR-PTB patients was (44.04±15.64) years. The (, ) direct medical expense of the patients was 134 051.00 (98 934.01,163 205.73) Yuan, of which the (,) reimbursement by health insurance or policy reduction was 100 462.10 (78 120.00,130 816.00) Yuan, and the (,) out-of-pocket direct medical expense was 21 694.62 (14 734.83,37 813.00) Yuan. The (,) direct non-medical expense was 4 971.00 (3 138.00,7 870.00) Yuan. Age, registered residence location, TB resulting in divorce or separation from spouse or partner, drug resistance test results, and treatment regimens were the influencing factors associated with out-of-pocket direct costs for MDR/RR-PTB patients. The direct economic burden caused by MDR/RR-PTB in Jiangsu Province is heavy. It is necessary to emphasize psychological guidance and care for MDR/RR-PTB patients, improve the diagnosis, treatment, and management of MDR/RR-PTB, and effectively reduce the economic burden of MDR/RR-PTB patients.
探讨江苏省耐多药/利福平耐药肺结核（MDR/RR-PTB）患者的直接经济负担及影响自付直接费用的因素。纳入2021年1月1日至2022年12月31日期间在江苏省13家市级结核病定点医院诊断并治疗的MDR/RR-PTB患者，通过问卷调查和医院信息系统获取基本信息和直接经济成本。采用逐步多元线性回归分析影响患者自付直接费用的因素。233例MDR/RR-PTB患者年龄为（44.04±15.64）岁。患者的（，）直接医疗费用为134051.00（98934.01，163205.73）元，其中医保报销或政策性减免为100462.10（78120.00，130816.00）元，（，）自付直接医疗费用为21694.62（14734.83，37813.00）元。（，）直接非医疗费用为4971.00（3138.00，7870.00）元。年龄、户籍所在地、结核病导致与配偶或伴侣离婚或分居、耐药检测结果及治疗方案是影响MDR/RR-PTB患者自付直接费用的相关因素。江苏省MDR/RR-PTB所致的直接经济负担较重。有必要重视对MDR/RR-PTB患者的心理疏导与关怀，提高MDR/RR-PTB的诊断、治疗及管理水平，有效减轻MDR/RR-PTB患者的经济负担。
