关键词: 结核, 肺, 政府补助, 评价研究

Abstract: Objective  To confirm the necessity and to explore the standard and proper way of providing transportation subsidies to pulmonary tuberculosis patients, in order to provide evidence for relative policy development.  Methods  Field test method was used: all of the 425 new smear positive tuberculosis patients(NSP) detected from April 1st to December 28th in 2008 both in Wuxi County and Shen County were selected as the intervention group, and 410 NSP registered in the corresponding period in 2007 as the control group. The transportation subsidies were given to the intervention group throughout the treatment period but in different ways in the two counties. Sputum examination rate at the end of 2nd, 5th and 6th month of treatment and on time drug taken rate were used to evaluate the effect. EpiData 3.0 and SPSS 11.5 were used to input and analyze the data. Descriptive statistics was used to analyze the socio-demographic characteristics of the subject investigated and chi-square test was applied to compare the treatment compliance between the two groups.  Results  The NSP in Wuxi County and Shen County needed (30.6±20.0) RMB and (22.2±10.1) RMB for one round trip respectively. 55.5% (231/416) of all the NSP reported that they couldn’t afford the traffic fees for 3-4 times follow-up during the treatment period. The average amount of the traffic subsidies provided to the NSP in Wuxi County and Shen County were (86.8±46.6) RMB and (59.2±23.3) RMB respectively. The sputum examination rate at the end of the 2nd month of treatment ［（Wuxi County χ²=67.523，P<0.05）,（Shen County  χ²=5.776，P<0.05）］ and the rate of on time drug taken ［（Wuxi County χ²=413.172,  P<0.05）,（Shen County  χ²=88.615，P<0.05）］during treatment period of the intervention group were higher than the control group. In Shen County the sputum examination rate at the end of the 5th （χ²=5.136,  P<0.05）and 6th treatment month (χ²=14.479,  P<0.05）of the intervention group were also higher than the control group. The vast majority of field staff considered that the implementation of transportation allowance was successful, as it helped the patients solve the practical difficulties and motivated patients to improve their treatment adherence.  Conclusion  The transportation subsidies could improve the patients’ adherence to treatment. The standard of the subsidy should be set according to the distance between patients’ home and the local TB dispensary, and it should be distributed at the beginning and after the complement of treatment.

Key words: Tuberculosis pulmonary, Public assitance, Evaluation studies