Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China.

Published

Journal Article

Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households. A number of studies have analyzed patient and household expenditure on TB care, but there does not appear to be any that have assessed the incidence, intensity and determinants of catastrophic health expenditure (CHE) relating to TB care in China. That will be the objective of this paper.The data used for this study were derived from the baseline survey of the China Government - Gates Foundation TB Phase II program. Our analysis included 747 TB cases. Catastrophic health expenditure for TB care was estimated using two approaches, with households defined as experiencing CHE if their annual expenditure on TB care: (a) exceeded 10 % of total household income; and (b) exceeded 40 % of their non-food expenditure (capacity to pay). Chi-square tests were used to identify associated factors and logistic regression analysis to identify the determinants of CHE.The incidence of CHE was 66.8 % using the household income measure and 54.7 % using non-food expenditure (capacity to pay). An inverse association was observed between CHE rates and household income level. Significant determinants of CHE were: age, household size, employment status, health insurance status, patient income as a percentage of total household income, hospitalization and status as a minimum living security household. Factors including gender, marital status and type of TB case had no significant associations with CHE.Catastrophic health expenditure incidence from TB care is high in China. An integrated policy expanding the free treatment package and ensuring universal coverage, especially the height of UHC for TB patients, is needed. Financial and social protection interventions are essential for identified at-risk groups.

Full Text

Duke Authors

Cited Authors

  • Zhou, C; Long, Q; Chen, J; Xiang, L; Li, Q; Tang, S; Huang, F; Sun, Q; Lucas, H

Published Date

  • January 25, 2016

Published In

Volume / Issue

  • 5 /

Start / End Page

  • 6 -

PubMed ID

  • 26806552

Pubmed Central ID

  • 26806552

Electronic International Standard Serial Number (EISSN)

  • 2049-9957

International Standard Serial Number (ISSN)

  • 2095-5162

Digital Object Identifier (DOI)

  • 10.1186/s40249-016-0100-6

Language

  • eng