Abstract
BackgroundHealth expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China.MethodsThree hundred fourty-seven TB cases are included in the analysis. We analyze the incidence and intensity of CHE and poverty, and assess the protective effect of NCMS by comparing the CHE and impoverishment before and after reimbursement.ResultsAfter out-of-pocket (OOP) payment for TB care, 16.1 % of non-poor fall below poverty line. The NCMS reduces the incidence of CHE and impoverishment by 11.5 % and 7.3 %. After reimbursement, 46.7 % of the households still experience CHE and 35.4 % are below the poverty line. The NCMS relieves the mean gap, mean positive gap, poverty gap and normalized positive gap by 44.5 %, 51.0 %, US$115.8 and 31.6 % respectively.ConclusionsThe NCMS has partial effect on protecting households from CHE and impoverishment from TB care. The limited protection could be enhanced by redesigning benefit coverage to improve the “height” of the NCMS and representing fee-for-service with alternative payment mechanisms.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0463-0) contains supplementary material, which is available to authorized users.
Highlights
Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty
The participants of this study are New Cooperative Medical Scheme (NCMS) enrollees. Those who are not covered by the scheme or who cannot afford the deductible are not included in our study, which would probably lead to an underestimation of incidence and intensity of catastrophic health expenditure (CHE) and impoverishment
Our findings show that the NCMS provide some financial protection for TB patients
Summary
Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China. The poor are at a high risk of TB infection and have higher TB prevalence and incidence [3,4,5,6,7]. TB contributes much to poverty by affecting negatively the labor supply which would result in a severe loss of future earning for patients’ families [3, 8,9,10]. Many studies have documented that TB patients incur high costs for diagnosis and treatment despite TB care offered
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