Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China

Int J Tuberc Lung Dis. 2013 Dec;17(12):1575-80. doi: 10.5588/ijtld.13.0144.

Abstract

Setting: A county in Jiangsu Province, China.

Objectives: 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.

Design: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / economics*
  • Antitubercular Agents / therapeutic use*
  • China
  • Cost of Illness
  • Cross-Sectional Studies
  • Drug Costs
  • Female
  • Health Care Costs*
  • Health Care Surveys
  • Health Expenditures*
  • Hospital Costs
  • Humans
  • Income
  • Male
  • Middle Aged
  • National Health Programs / economics
  • Rural Health Services / economics*
  • Sick Leave / economics
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / economics*
  • Young Adult

Substances

  • Antitubercular Agents