ArticleInfectious diseases of poverty2019
Impact of an innovative tuberculosis financing and payment model on health service utilization by tuberculosis patients in China: do the poor fare better than the rich?
Article in Infectious diseases of poverty, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Reforming China's retail prescription medicine purchasing system: evidence from retail pharmacies in Wuhan.BMC health services research · 2026Article
- Medical insurance-related professionals' identification of the benefits of the medical insurance system in Northeast China: a cross-sectional study.BMC health services research · 2025Article
- 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
- 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
- Factors Associated with Medication Adherence in Elderly Individuals with Tuberculosis: A Qualitative Study.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023Article
- Perceptions of the benefits of the basic medical insurance system among the insured: a mixed methods research of a northern city in China.Frontiers in public health · 2023Article
- Scale-up of a comprehensive model to improve tuberculosis control in China: lessons learned and the way forward.Infectious diseases of poverty · 2021Article
- Association between economic development level and tuberculosis registered incidence in Shandong, China.BMC public health · 2020Article
- Does communicable diseases (including COVID-19) may increase global poverty risk? A cloud on the horizon.Environmental research · 2020Article
- A New Financing Model for Tuberculosis (TB) Care in China: Challenges of Policy Development and Lessons Learned from the Implementation.International journal of environmental research and public health · 2020Review
- The year 2020, a milestone in breaking the vicious cycle of poverty and illness in China.Infectious diseases of poverty · 2020Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundTuberculosis (TB) prevalence is closely associated with poverty in China, and poor patients face more barriers to treatment. Using an insurance-based approach, the China-Gates TB program Phase II was implemented between 2012 and 2014 in three cities in China to improve access to TB care and reduce the financial burden on patients, particularly among the poor. This study aims to assess the program effects on service use, and its equity impact across different income groups.
methodsData from 788 and 775 patients at baseline and final evaluation were available for analysis respectively. Inpatient and outpatient service utilization, treatment adherence, and patient satisfaction were assessed before and after the program, across different income groups (extreme poverty, moderate poverty and non-poverty), and in various program cities, using descriptive statistics and multi-variate regression models. Key stakeholder interviews were conducted to qualitatively evaluate program implementation and impacts.
resultsAfter program implementation, the hospital admission rate increased more for the extreme poverty group (48.5 to 70.7%) and moderate poverty group (45.0 to 68.1%), compared to the non-poverty group (52.9 to 64.3%). The largest increase in the number of outpatient visits was also for the extreme poverty group (4.6 to 5.7). The proportion of patients with good medication adherence increased by 15 percentage points in the extreme poverty group and by ten percentage points in the other groups. Satisfaction rates were high in all groups. Qualitative feedback from stakeholders also suggested that increased reimbursement rates, easier reimbursement procedures, and allowance improved patients' service utilization. Implementation of case-based payment made service provision more compliant to clinical pathways.
conclusionPatients in extreme or moderate poverty benefited more from the program compared to a non-poverty group, indicating improved equity in TB service access. The pro-poor design of the program provides important lessons to other TB programs in China and other countries to better address TB care for the poor.
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