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财政支持对耐多药结核病治疗结果的影响:一项基于人群的中国上海回顾性队列研究。

Impact of financial support on treatment outcomes of multidrug-resistant tuberculosis: A population-based, retrospective cohort study in Shanghai, China.

作者信息

Chen Yong, Shen Xin, Zhang Yi, Wu Zheyuan, Xu Biao, Chen Jing, Sha Wei, Liu Xiaoxia, Ning Chenxi

机构信息

Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.

Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

J Clin Tuberc Other Mycobact Dis. 2024 Nov 29;37:100500. doi: 10.1016/j.jctube.2024.100500. eCollection 2024 Dec.

Abstract

BACKGROUND

To date, the prolonged treatment duration and expensive second-line anti-tuberculosis drugs (SLDs) for multidrug-resistant tuberculosis (MDR-TB) can impose a significant financial burden, which may negatively impact treatment outcomes. This study examines the effect of a subsidy policy on treatment outcomes of MDR-TB patient..

METHODS

We collected demographic and drug resistance data of all registered MDR-TB patients between April 2011 and December 2019 in Shanghai, China. Documentation of financial support received was routinely maintained until December 2021. We employed multivariate logistic regression to assess the association between financial support and treatment outcomes, estimating odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).

RESULTS

Of the 865 patients, 70.6% (611/865) achieved treatment success. The median amount compensated under the subsidy policy was 2359 United States dollar (USD), with an interquartile range from 1116 to 5652 USD. A positive association was found between benefiting from the subsidy policy and higher rate of treatment success, with an adjusted OR of 2.95 (95% CI, 2.03-4.28). Among the 641 patients covered by the policy, the adjusted OR comparing those with higher versus lower reimbursement was 1.74 (95% CI, 1.16-2.61).

CONCLUSIONS

Financial support policies for MDR-TB patients demonstrate a positive influence on treatment outcomes.

摘要

背景

迄今为止,耐多药结核病(MDR-TB)的治疗周期延长且二线抗结核药物昂贵,这可能带来巨大的经济负担,进而对治疗结果产生负面影响。本研究探讨了一项补贴政策对耐多药结核病患者治疗结果的影响。

方法

我们收集了2011年4月至2019年12月期间在中国上海所有登记的耐多药结核病患者的人口统计学和耐药数据。直至2021年12月,我们一直定期记录所获得的财政支持情况。我们采用多因素逻辑回归来评估财政支持与治疗结果之间的关联,估算比值比(OR)及其相应的95%置信区间(CI)。

结果

865名患者中,70.6%(611/865)获得治疗成功。补贴政策下的补偿中位数为2359美元,四分位间距为1116至5652美元。研究发现,受益于补贴政策与更高的治疗成功率之间存在正相关,调整后的OR为2.95(95%CI,2.03 - 4.28)。在该政策覆盖的641名患者中,比较高报销与低报销患者的调整后OR为1.74(95%CI,1.16 - 2.61)。

结论

耐多药结核病患者的财政支持政策对治疗结果具有积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/190b/11650311/c102924636aa/gr1.jpg

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