OBJECTIVES: To assess equity in access to tuberculosis (TB) care by estimating and comparing the direct household costs perceived by community residents with actual costs experienced by TB patients and to identify the factors influencing the financial burden of TB patients. METHODS: Economic study in four provinces of China by means of a survey of 889 TB patients and 2560 community residents and in-depth interviews with key informants. RESULTS: The direct household costs for using TB health services perceived by the communities were two to five times higher than the actual costs incurred by the TB patients. Patients had to pay a substantial proportion of their annual income for TB services (12-40%), despite the fact that smear-positive and some severe smear-negative patients received free drugs. Repeated outpatient visits before diagnosis, over-prescription of drugs and prolonged treatments were common. CONCLUSIONS: The heavy financial burden (both perceived and real) on these patients is one of the main reasons that some TB patients fail to access and complete treatment. Pressure to generate revenue through current incentives in health-care financing and poor competence of health workers at the village and township levels cause delay and high expenses to TB patients and ultimately impede effective TB control in China.
OBJECTIVES: To assess equity in access to tuberculosis (TB) care by estimating and comparing the direct household costs perceived by community residents with actual costs experienced by TB patients and to identify the factors influencing the financial burden of TB patients. METHODS: Economic study in four provinces of China by means of a survey of 889 TB patients and 2560 community residents and in-depth interviews with key informants. RESULTS: The direct household costs for using TB health services perceived by the communities were two to five times higher than the actual costs incurred by the TB patients. Patients had to pay a substantial proportion of their annual income for TB services (12-40%), despite the fact that smear-positive and some severe smear-negative patients received free drugs. Repeated outpatient visits before diagnosis, over-prescription of drugs and prolonged treatments were common. CONCLUSIONS: The heavy financial burden (both perceived and real) on these patients is one of the main reasons that some TB patients fail to access and complete treatment. Pressure to generate revenue through current incentives in health-care financing and poor competence of health workers at the village and township levels cause delay and high expenses to TB patients and ultimately impede effective TB control in China.
Authors: Y Lin; D A Enarson; C-Y Chiang; I D Rusen; L-X Qiu; X-H Kan; Y-L Yuan; J Du; T-H Zhang; Y Li; X-F Li; C-T Du; L-X Zhang Journal: Public Health Action Date: 2015-03-21
Authors: Song Yao; Wen-Hui Huang; Susan van den Hof; Shu-Min Yang; Xiao-Lin Wang; Wei Chen; Xue-Hui Fang; Hai-Feng Pan Journal: BMC Health Serv Res Date: 2011-12-16 Impact factor: 2.655
Authors: Hua Jianzhao; Susan van den Hof; Xu Lin; Qiu Yubang; Hou Jinglong; Marieke J van der Werf Journal: BMC Health Serv Res Date: 2011-05-11 Impact factor: 2.655
Authors: Luis Eduardo Cuevas; Mohammed Ahmed Yassin; Najla Al-Sonboli; Lovett Lawson; Isabel Arbide; Nasher Al-Aghbari; Jeevan Bahadur Sherchand; Amin Al-Absi; Emmanuel Nnamdi Emenyonu; Yared Merid; Mosis Ifenyi Okobi; Juliana Olubunmi Onuoha; Melkamsew Aschalew; Abraham Aseffa; Greg Harper; Rachel Mary Anderson de Cuevas; Kristin Kremer; Dick van Soolingen; Carl-Michael Nathanson; Jean Joly; Brian Faragher; Stephen Bertel Squire; Andrew Ramsay Journal: PLoS Med Date: 2011-07-12 Impact factor: 11.069