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Tuberculosis patient expenditure on drugs and tests in subsidised, public services in China: a descriptive study

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Liu, Qin, Smith, Helen ORCID: https://orcid.org/0000-0002-6252-3793, Wang, Yang, Tang, Shenglan, Wang, Qingliang and Garner, Paul ORCID: https://orcid.org/0000-0002-0607-6941 (2010) 'Tuberculosis patient expenditure on drugs and tests in subsidised, public services in China: a descriptive study'. Tropical Medicine & International Health, Vol 15, Issue 1, pp. 26-32.

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Abstract

Summary Objective

To measure patient expenditure on additional drugs and tests in public services where tuberculosis (TB) drugs are supplied for free. Methods

Questionnaire survey of patients currently on treatment in eight TB dispensaries in two provinces; in depth interviews with providers at the facilities. Results

Liver protection drugs (141/163) were prescribed for 86% of patients, 93% had one or more tests in the last month, and 23% were on treatment past the World Health Organization-recommended treatment duration. All but two patients were charged for something in cash at each visit: on average 287 Chinese Yuan (40 US dollars) in the previous month. For patients below the poverty line, drug and test expenditure was 1.85 times their average household monthly income. Average charges varied little between income categories. In terms of anti-TB drugs prescribed, 17.8% of regimens were inadequate by international standards. Providers reported they prescribe liver protection drugs to avoid medical negligence, and they believed they were effective; and the government subsidy for providing TB treatment was simply not enough. Conclusions

Despite an ostensibly fully subsidised TB programme in China, patients are charged substantive amounts irrespective of income. Research is needed to confirm these practices are widespread but this needs to be coupled with financing strategies to tackle it.

Item Type: Article
Additional Information: Checked Romeo and is a yellow publisher and it says can only archive post print version subject to Restrictions - 1. only allowed with written permission 2. 0-24 months depending on journal I have uploaded the post print version and put an embargo date of 24 months.
Uncontrolled Keywords: Tuberculosis; China; costs; treatment; liver protection drugs
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WF Respiratory System > Tuberculosis > WF 360 Drug therapy
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WA Public Health > WA 100 General works
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1365-3156.2009.02427
Depositing User: q Moody
Date Deposited: 22 Jul 2010 14:39
Last Modified: 22 Feb 2018 15:54
URI: http://archive.lstmed.ac.uk/id/eprint/1075

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