关键词: 结核,肺/经济学, 抗药性,多种,细菌, 按诊疗收费计划

Abstract: Objective  To develop standardized medical service package of multi-drug resistant tuberculosis (MDR-TB) so as to provide evidence for the promotion of free health care policy for MDR-TB. Methods  Experts meetings were organized to establish the MDR-TB medical services package. The MDR-TB medical services package includes seven categories: diagnosis, pre-admission examination, hospitalization, follow-up, psychological support, treatment of complications, adverse reaction and DOT. To analyze the expenses of medical services package based on the actual price of medical services in the four prefecture level designated hospitals. Results  The average expenses of services package for the whole course of MDR-TB treatment is 32 617 yuan. Of all service categories, the highest incurs in drug expenses with an average of 13 722 yuan, accounting for 42.07％(13 722/32 617) of the average total cost. Of the agencies, the largest is spent in the prefecture level hospital with an average of 26 527 yuan, accounting for 81.33％(26 527/32 617) of the average total. In 24-month treatment of MDR-TB patients, the highest expenses is incurred in the first and second month of hospitalization. The expenses of the first and second month is 5879 yuan and 2651 yuan, accounting for 18.02％（5879/32 617）and 8.13％（2651/32 617） of the total respectively. Conclusion  MDR-TB medical service package is mainly used to standardize medical service behaviors, limits medical expenses, and provides reference for the promotion of standardized MDR-TB treatment.

Key words: Tuberculosis,pulmonary/economics, Drug resistance,multiple,bacterial, Fee-for-service plans