Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study.
Repository Usage Stats
OBJECTIVE:The China Center for Disease Control and Prevention (CDC) introduced an innovative financing model of tuberculosis (TB) care and control with the aim of standardizing TB treatment and reducing the financial burden associated with patients with TB. This is a study of the pilot implementation of new financing mechanism in Zhenjiang, between 2014-2015. We compared TB hospitalization rates and inpatient service costs before and after implementation to examine the factors associated with hospital admissions. Our goal is to provide evidence-based recommendations for improving TB service provision and cost control. METHODS:We reviewed new policy documents on TB financing. We conducted a patient survey to investigate the utilization of inpatient services, and patients' out-of-pocket payment for inpatient care. We extracted total medical expenditures of inpatient services from inpatient records of TB designated hospitals. FINDINGS:63.6% (n = 159) of the surveyed patients with TB were admitted for treatment in 2015, which was higher than that in 2013 (54.8%, n = 144). The number of hospital admission was slightly lower in 2015 (1.16 per patient) than in 2013 (1.26 per patient), while the length of hospital stay was longer in 2015 (24 days) than in 2013 (16 days). In 2015, patients from families with low incomes were more likely to be admitted than those from higher income groups (OR = 3.06, 95% CI: 1.12-8.33). The average inpatient service cost in 2015 (3345 USD) was 1.7 times the cost in 2013 (1952 USD). It was found that 96.2% of patients with TB who were from low-income households spent more than 20% of their household income on inpatient care in 2013, versus 100% in 2015. CONCLUSION:The TB hospital admission rate and total inpatient service cost increased over the study period. The majority of patients with TB, particularly poor patient who used inpatient care, continue to suffer from heavy financial burden.
Published Version (Please cite this version)10.3390/ijerph16152750
Publication InfoJi, John; Hu, Dan; Long, Qian; Chen, Jiaying; Wang, Xuanxuan; & Huang, Fei (2019). Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study. International journal of environmental research and public health, 16(15). pp. 2750-2750. 10.3390/ijerph16152750. Retrieved from https://hdl.handle.net/10161/19309.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Assistant Professor of Environmental Health Science at Duke Kunshan University
John S. Ji is Assistant Professor of Environmental Health Science at Duke Kunshan University, and holds a secondary appointment in the Division of Environmental Science & Policy in the Nicholas School of the Environment at Duke University. John is the Director of Graduate Studies for the international Masters of Environmental Policy (iMEP) program at DKU. John’s research interests are in environmental health, gene-environment interaction, neuro-epidemiology, and the UN Sustainable D