Abstract
BackgroundPTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries.MethodsThe quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes.ResultsAfter implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%.ConclusionsThe capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.
Highlights
pulmonary tuberculosis (PTB) is an infectious disease, which seriously affects people’s health, and causes a heavier disease economic burden on patients
From 2015 to 2017, the number of patient visits to the hospital decreased year by year, but after the implementation of the payment method reform in 2017, the number of visits of PTB patients in 2018 increased by 14.2%, and both outpatients and inpatients increased
Compared with the decrease of 2.9% in the new incidence of PTB in the region (Jilin Province) in 2018, it can be seen that the implementation of the payment method reform played a certain role in the recovery of the number of PTB patients in the hospital (Table 4)
Summary
PTB is an infectious disease, which seriously affects people’s health, and causes a heavier disease economic burden on patients. Our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. PTB has become the second leading cause of death from infectious diseases, after AIDS [2]. Eighty percent of PTB patients are concentrated in rural areas, and the economic burden of the disease is heavy. PTB has become one of the major diseases that sends individuals back into poverty due to illness, initially causing poverty due to illness and restricting rural social and economic development [3]
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