Two hundred and sixty-five PTB patients registered for derating treatment fees at Zhabei District Center for Disease Control and Prevention from July 2015 to July 2016 were recruited to participate in this study. The invoices of non-derated medical costs were collected and questionnaire survey on satisfaction with the derating policy was conducted. A total of 265 questionnaires were sent out and 213 valid questionnaires were collected (all 213 patients were aware of the derating policy). The effective response rate was 80.4%. Basic characteristics including demographic data, treatment and medication data were collected; Ranksum test was used to compare the costs supported by government financial between patients with different characteristics; the costs at patients’ own expense on the related examinations and medicines were calculated; and the satisfaction with the derating policy were also analyzed by using questionnaire.

The median exempted costs of the total medical expenses for the 213 patients was 1766 (1020, 2411) RMB (quartile (Q₁, Q₃)), of which 655 (377, 900) RMB for medical examinations, 325 (165, 493) RMB for first-line anti-TB drugs, 293 (85, 733) RMB for second-line anti-TB drugs, and 800 (156, 800) RMB for hepatoprotective drugs, respectively. Among the non-exempted costs, the times of kidney function test and blood routine examination were 6.4 and 6.6 per patient, resulting in average fees of 156.8 (33388/213) and 79.6 (16954/213) RMB, respectively; the average cost at patients’ own expense on auxiliary drugs (such as anti-TB Traditional Chinese Medicine Patent Prescription) was 684.8 RMB. The overall satisfaction rate of patients with derating policy was 77.5% (165/213). With regard to first-line anti-TB drugs, hepatoprotective drugs, medical examinations and process of derating, the satisfaction rates were 90.1% (192/213), 77.9% (166/213), 83.1% (177/213) and 90.6% (193/213), respectively. 65.3% (139/213) of the patients believed that hepatoprotective drugs account for the majority of the total treatment costs. For the current derating policy, the proportion of patients who chose “The items that can be derated were limited” or “The costs that can be derated were low” were 51.2% (109/213) and 34.7% (74/213), respectively. The most expected item to be implemented on the basis of current policy was derating the expenses when treating at designated hospital (45.5%, 97/213).

The overall satisfaction rate of the patients with derating policy is low in Zhabei district. Considering the actual treatment situation of patients in this district, we should increase derated costs of some examinations and medicines.