RESUMEN
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.
Asunto(s)
Antituberculosos/economía , Antituberculosos/uso terapéutico , Costos de la Atención en Salud , Gastos en Salud , Servicios de Salud Rural/economía , Tuberculosis/tratamiento farmacológico , Tuberculosis/economía , Absentismo , Adolescente , Adulto , Anciano , Antituberculosos/efectos adversos , China , Costo de Enfermedad , Estudios Transversales , Costos de los Medicamentos , Femenino , Encuestas de Atención de la Salud , Costos de Hospital , Humanos , Renta , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud/economía , Ausencia por Enfermedad/economía , Tuberculosis/diagnóstico , Adulto JovenRESUMEN
In this paper, the effect of V.C on thermal sensitivity of the tumor and normal tissues was studied. Average peak reaction and RD50 (50% reaction dosage) were used to evaluate the effect of V.C on thermal sensitivity of the normal tissue. Tumor cure rate and TCD50 (50% tumor cure dosage) were used to evaluate the effect of V.C on that of the tumor tissue. In all mice injected by V.C locally, the average peak reaction markedly increased, RD50 decreased by 1-2 fold; the tumor cure rate was obviously elevated, TCD50 was significantly reduced except those treated by 20' hyperthermia. TGF (therapeutic gain factor) was 1.76. These results indicate that V.C can increase the thermal sensitivity of tumor and normal tissues but the effect on tumor tissue is selective.