The affordability for patients of a new universal MDR-TB coverage model in China.
Int J Tuberc Lung Dis
; 20(5): 638-44, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-27084818
ABSTRACT
BACKGROUND:
China has piloted a new model of universal coverage for multidrug-resistant tuberculosis (MDR-TB), designed to rationalize hospital use of drugs and tests and move away from fee-for-service payment towards a standard package with financial protection against catastrophic health costs.OBJECTIVE:
To evaluate the affordability to patients of this new model.DESIGN:
This was an observational study of 243 MDR-TB cases eligible for enrolment on treatment under the project. We assessed the affordability of the project from the perspective of households, with a focus on catastrophic costs.RESULTS:
Of the 243 eligible cases, 172 (71%) were enrolled on treatment; of the 71 cases not enrolled, 26 (37%) cited economic reasons. The 73 surveyed cases paid an average of RMB 5977 (US$920) out-of-pocket in search costs incurred outside the pilot model. Within the pilot, they paid another RMB 2094 (US$322) in medical fees and RMB 5230 (US$805) in direct non-medical costs. Despite 90% reimbursement of medical fees, 78% of households experienced catastrophic costs, including indirect costs.CONCLUSION:
The objectives of the pilot model are aligned with health reform in China and universal health coverage globally. Enrollment would almost certainly be higher with 100% reimbursement of medical fees, but patient enablers will be required to truly eliminate catastrophic costs.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
10_ODS3_salud_sexual_reprodutiva
/
11_ODS3_cobertura_universal
/
1_ASSA2030
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2_ODS3
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3_ND
Base de dados:
MEDLINE
Assunto principal:
Custos de Medicamentos
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Gastos em Saúde
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Tuberculose Resistente a Múltiplos Medicamentos
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Cobertura Universal do Seguro de Saúde
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Atenção à Saúde
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Seguro Saúde
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Programas Nacionais de Saúde
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Antituberculosos
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adolescent
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Adult
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Child
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Child, preschool
/
Female
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Humans
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Infant
/
Male
/
Middle aged
/
Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2016
Tipo de documento:
Article