Abstract:

Objective: To formulate clinical service packages required by different types of pulmonary tuberculosis and make estimation on direct medical costs accordingly. Results of estimation will be used to inform policy recommendations on optimized allocation of funds dedicated for tuberculosis prevention, promotion of multi-channel financing as well as further alleviation of financial burden of tuberculosis patients. Methods: According to China’s current tuberculosis prevention and control strategy, technical recommendations and clinical pathways, also in consideration of current capacity and clinical practices in tuberculosis designated hospitals at all levels, adoption and potential upgrade of new control strategy as well as application of new technologies and interventions in the future, this study had formulated different clinical service packages for different types of pulmonary tuberculosis patients and calculated the direct cost incurred by individual patient during diagnosis and treatment as well as total cost of these packages by multiplying the numbers of these different pulmonary tuberculosis patient groups in China. Results: Direct cost for a rifampicin-susceptible pulmonary tuberculosis patient was about 15370 Yuan, that of a rifampicin-resistant pulmonary tuberculosis patient was about 196585 Yuan. The annual budget required to cover the total direct medical cost of all pulmonary tuberculosis patients in China was about 14.69 billion Yuan with an average annual investment of 10 Yuan per capita, of which total medical cost for rifampicin-susceptible pulmonary tuberculosis patients accounts for 10.76 billion Yuan (73.2%, 10.76/14.69), that of rifampicin-resistant pulmonary tuberculosis patients was 3.93 billion Yuan (26.8%, 3.93/14.69). Of total medical cost, 8.31 billion Yuan (56.6%, 8.31/14.69) was incurred by outpatient cost; 6.38 billion Yuan (43.4%, 6.38/14.69) was inpatient cost. Conclusion: The estimates come out of this study have provided promotion of multi-channel financing, overall budgeting and allocation of funds dedicated for tuberculosis prevention and control, development of feasible medical cost alleviation and concession policy for tuberculosis patients with valuable references.

Key words: Tuberculosis, pulmonary, Fees, medical, Needs assessment