Show simple item record

Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study.

dc.contributor.author Ji, John
dc.contributor.author Hu, Dan
dc.contributor.author Long, Qian
dc.contributor.author Chen, Jiaying
dc.contributor.author Wang, Xuanxuan
dc.contributor.author Huang, Fei
dc.date.accessioned 2019-09-10T22:56:25Z
dc.date.available 2019-09-10T22:56:25Z
dc.date.issued 2019-08
dc.identifier ijerph16152750
dc.identifier.issn 1661-7827
dc.identifier.issn 1660-4601
dc.identifier.uri https://hdl.handle.net/10161/19309
dc.description.abstract 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.
dc.language eng
dc.publisher MDPI AG
dc.relation.ispartof International journal of environmental research and public health
dc.relation.isversionof 10.3390/ijerph16152750
dc.subject China
dc.subject Tuberculosis
dc.subject financial burden
dc.subject health financing and payment
dc.subject hospital admission rates
dc.title Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study.
dc.type Journal article
dc.date.updated 2019-09-10T22:56:23Z
pubs.begin-page 2750
pubs.end-page 2750
pubs.issue 15
pubs.organisational-group Duke Kunshan University
pubs.organisational-group Duke
pubs.organisational-group Duke Kunshan University Faculty
pubs.publication-status Published
pubs.volume 16
duke.contributor.orcid Ji, John|0000-0002-5002-118X


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record