ArticleInfectious diseases of poverty2016
The impact of the new cooperative medical scheme on financial burden of tuberculosis patients: evidence from six counties in China.
Article in Infectious diseases of poverty, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients.Scientific reports · 2022Pooled it
- Assessing intervention effects on healthcare-related financial protection in low- and middle-income countries: a rapid evidence review.Health policy and planning · 2026Review
- The impact of social protection interventions on treatment and socioeconomic outcomes of tuberculosis-affected people and households in low income, high burden settings: A systematic review and meta-analysis.PLOS global public health · 2026Article
- What influences the impact of health financing reforms? Using qualitative comparative analysis to identify patterns in health financing systems and their effects on financial protection.SSM - health systems · 2025Review
- Impact of diagnosis-related group payment on medical expenditure and treatment efficiency on people with drug-resistant tuberculosis: a quasi-experimental study design.International journal for equity in health · 2025Article
- Household economic burden and catastrophic expenditures in non-resistant tuberculosis patients: cross-sectional survey in Guizhou, China.Frontiers in public health · 2025Article
- Health insurance's contribution to reducing the financial burden of tuberculosis in Guizhou Province, China.Epidemiology and infection · 2024Article
- Social protection as a right of people affected by tuberculosis: a scoping review and conceptual framework.Infectious diseases of poverty · 2023Article
- Social Protection Interventions for TB-Affected Households: A Scoping Review.The American journal of tropical medicine and hygiene · 2023Article
- Impacts of Medical Security Level on Treatment Outcomes of Drug-Resistant Tuberculosis: Evidence from Wuhan City, China.Patient preference and adherence · 2022Article
- Association of migration status with quality of life among rural and urban adults with rare diseases: A cross-sectional study from China.Frontiers in public health · 2022Article
- A qualitative study of perspectives on access to tuberculosis health services in Xigaze, China.Infectious diseases of poverty · 2021Article
- Urban-rural differences in healthcare utilization among beneficiaries in China's new cooperative medical scheme.BMC public health · 2021Article
- Article
- Impact of reimbursement rates on the length of stay in tertiary public hospitals: a retrospective cohort study in Shenzhen, China.BMJ open · 2020Article
- What contributes to medical debt? Evidence from patients in rural China.BMC health services research · 2020Article
- What causes high costs for rural tuberculosis inpatients? Evidence from five counties in China.BMC infectious diseases · 2020Article
- Factors associated with catastrophic total costs due to tuberculosis under a designated hospital service model: a cross-sectional study in China.BMC public health · 2020Article
- Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China.International journal of environmental research and public health · 2020Article
- Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis (TB) patients in China encounter heavy financial burdens throughout the course of their treatment and it is unclear how China's health insurance systems affect the alleviation of this burden under the integrated approach. This study aimed to measure reimbursement for TB services under the New Cooperative Medical Scheme (NCMS) in rural China and to evaluate changes in catastrophic health expenditure (CHE) caused by the reimbursement policies.
methodsReimbursement data were obtained from routine data systems for the NCMS in Yichang (YC) and Hanzhong (HZ). 1884 TB inpatients reimbursed by NCMS from 2010 to 2012 were included. Household surveys were conducted. A total of 494 TB patients under the NCMS were selected in this paper. 12 Focus Group Discussions (FGDs) were held. We measured the impact of the NCMS by counterfactual analysis, which analyzed the financial burden alleviation. Equity was assessed by Concentration Index (CI), and disaggregated by project sites.
resultsTB inpatients were reimbursed with an effective reimbursement rate of 57.3 %. Average out-of-pocket (OOP) payments for outpatient and inpatient services after diagnosis were 1413 yuan and 430 yuan, and 3572 yuan and 3013 yuan in YC and HZ, respectively. The reimbursement level for TB outpatient care after diagnosis was very low due to a limited outpatient quota. TB patients in HZ incurred higher effective reimbursement rates, but the incidence of CHE remained higher. The reduction of CHE incidence after the NCMS showed no difference statistically (P > 0.05). The severity of CHE was alleviated slightly. CIs after reimbursement were all below zero and their absolute values were higher than those before reimbursement.
conclusionsLow reimbursement for TB patients could lead to heavy financial burden. Poor TB patients incurred high rates of CHE. The NCMS was found to be a protective factor for CHE, but the impact was modest and the equity of CHE did not improve. The NCMS reimbursement policies should be improved in the future to include a more comprehensive coverage of care. Supplemental programs may be necessary to expand coverage for TB care.
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