Progress in catastrophic health expenditures for tuberculosis

doi:10.19982/j.issn.1000-6621.20230345

Abstract

Abstract:

China is one of the countries with the highest number of tuberculosis cases and high burden in the world, and the heavy catastrophic health expenditure poses a daunting task and challenge to patients, families and society in China, making it impossible to implement tuberculosis prevention and control measures thoroughly. The authors reviewed the definition, research status, and influencing factors of catastrophic health expenditure, aiming to explore the research deficiencies in China, provide suggestions and references for future research and policy-making.

Key words: Tuberculosis, Catastrophic illness, economics, Health expenditures, Review literature as topic

CLC Number:

Wang Jiani, Xi Mingxia. Progress in catastrophic health expenditures for tuberculosis[J]. Chinese Journal of Antituberculosis, 2024, 46(1): 112-118. doi: 10.19982/j.issn.1000-6621.20230345

Figures/Tables 2

References 51

[1]	李兰娟, 任红. 传染病学. 9版. 北京: 人民卫生出版社, 2018: 212.
[2]	World Health Organization.Global tuberculosis report 2022. Geneva: World Health Organization, 2022.
[3]	O’Donnell O, van Doorslaer E, Wagstaff A, et al. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation. Washington: World Bank, 2008.
[4]	Xu K, Evans DB, Carrin G, et al. Designing health financing systems to reduce catastrophic health expenditure. Grand Street, 2005(43):32-52. doi:/entity/health_financing/documents/cov-pb_e_05_2-cata_sys/en/ind.
[5]	王虹, 赵燕, 丁妥, 等. 农村家庭灾难性卫生支出界定标准探讨——以河北省迁西县为例. 经济师, 2016(11): 132-133. doi:10.3969/j.issn.1004-4914.2016.11.062.
[6]	Merlis ML. Family Out-of-Pocket Spending for Health Services:A Continuing Source of Financial Insecurity. New York: Commonwealth Fund, 2002.
[7]	World Health Organization, World Bank. Global Monitoring Report on Financial Protection in Health 2021. Geneva: World Health Organization and World Bank, 2021.
[8]	Nguyen HA, Ahmed S, Turner HC. Overview of the main methods used for estimating catastrophic health expenditure. Cost Effect Resour Alloc, 2023, 21(1): 50. doi:10.1186/s12962-023-00457-5.
[9]	Carletto G, Covarrubias K, Davis B, et al. Rural Income Generating Activities Study: Methodological note on the construction of income aggregates. Washington: Food and Agriculture Organization of the United Nations, 2007.
[10]	Davis B, Di Giuseppe S, Zezza A. Are African households (not) leaving agriculture? Patterns of households’ income sources in rural Sub-Saharan Africa. Food Policy, 2017, 67: 153-174. doi:10.1016/j.foodpol.2016.09.018.
[11]	Wagstaff A, Eozenou P, Smitz M. Out-of-Pocket Expenditures on Health: A Global Stocktake. Washington: World Bank, 2019.
[12]	Russell J, Lechner A, Hanich Q, et al. Assessing food security using household consumption expenditure surveys (HCES): a scoping literature review. Public Health Nutr, 2018, 21(12): 2200-2210. doi:10.1017/S136898001800068X. pmid: 29656716
[13]	岳希明, 胡一凡, 李禛临. 社会政策体系中的基本生活需要: 内涵与测量. 经济学动态, 2023(4): 42-58.
[14]	Grepin KA, Irwin BR, Sas TB. On the Measurement of Financial Protection: An Assessment of the Usefulness of the Catastrophic Health Expenditure Indicator to Monitor Progress Towards Universal Health Coverage. Health Syst Reform, 2020, 6(1): e1744988. doi:10.1080/23288604.2020.1744988.
[15]	Pal R. Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India. Int J Health Care Finance Econ, 2012, 12(1): 63-85. doi:10.1007/s10754-012-9103-4.
[16]	Goryakin Y, Suhrcke M. The prevalence and determinants of catastrophic health expenditures attributable to non-communicable diseases in low- and middle-income countries: a methodological commentary. Int J Equity Health, 2014, 13: 107. doi:10.1186/s12939-014-0107-1. pmid: 25376485
[17]	Xu K, Evans DB, Kawabata K, et al. Household catastrophic health expenditure: a multicountry analysis. Lancet, 2003, 362(9378): 111-117. doi:10.1016/S0140-6736(03)13861-5. pmid: 12867110
[18]	Assebe LF, Negussie EK, Jbaily A, et al. Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey. BMJ Open, 2020, 10(6): e36892. doi:10.1136/bmjopen-2020-036892.
[19]	Saqib SE, Ahmad MM, Amezcua-Prieto C. Economic burden of tuberculosis and its coping mechanism at the household level in Pakistan. Soc Sci J, 2018, 55(3): 313-322. doi:10.1016/j.soscij.2018.01.001.
[20]	Eze P, Lawani LO, Agu UJ, et al. Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis. Bull World Health Organ, 2022, 100(5): 337-351 J. doi:10.2471/BLT.21.287673.
[21]	Duan W, Zhang W, Wu C, et al. Extent and determinants of catastrophic health expenditure for tuberculosis care in Chongqing municipality, China: a cross-sectional study. BMJ Open, 2019, 9(4): e26638. doi:10.1136/bmjopen-2018-026638.
[22]	孙晓英, 程俊, 边学峰, 等. 山东省初治肺结核患者直接费用及疾病经济负担分析. 中国热带医学, 2020, 20(2): 126-130. doi:10.13604/j.cnki.46-1064/r.2020.02.07.
[23]	陈丽金, 周颖, 钟云, 等. 广东省耐多药结核病患者疾病经济负担研究. 中国卫生经济, 2021, 40(3): 72-75.
[24]	Diallo A, Combary A, Bakyono R, et al. A 2020 baseline assessment for the monitoring of the End TB indicator of catastrophic costs in Burkina Faso. Int J Tuberc Lung Dis, 2022, 26(10): 970-977. doi:10.5588/ijtld.22.0014.
[25]	Kastor A, Mohanty SK. Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing? PLoS One, 2018, 13(5): e196106. doi:10.1371/journal.pone.0196106.
[26]	Watts K. Is Australia Neglecting the Local Topography When It Comes to Catastrophic Costs and Ending Tuberculosis? Trop Med Infect Dis, 2018, 3(4): 126. doi:10.3390/tropicalmed3040126.
[27]	World Health Organization. Tuberculosis patient cost surveys: a handbook. Geneva: World Health Organization, 2017.
[28]	Getahun B, Wubie M, Dejenu G, et al. Tuberculosis care strategies and their economic consequences for patients: the missing link to end tuberculosis. Infect Dis Poverty, 2016, 5(1): 93. doi:10.1186/s40249-016-0187-9. pmid: 27799063
[29]	Zhou C, Long Q, Chen J, et al. Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China. Infect Dis Poverty, 2016, 5: 6. doi:10.1186/s40249-016-0100-6. pmid: 26806552
[30]	Kirubi B, Ong’Ang’o J, Nguhiu P, et al. Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya. Infect Dis Poverty, 2021, 10(1): 95. doi:10.1186/s40249-021-00879-4. pmid: 34225790
[31]	张广川. 广州市耐多药肺结核经济负担及影响因素分析. 广州: 广东药科大学, 2021. doi:10.27690/d.cnki.ggdyk.2021.000168.
[32]	Okedo-Alex IN, Akamike IC, Ezeanosike OB, et al. A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage. Int J Health Plann Manage, 2019, 34(4): e1387-e1404. doi:10.1002/hpm.2847.
[33]	Yadav J, John D, Allarakha S, et al. Rising healthcare expenditure on tuberculosis: Can India achieve the End TB goal? Trop Med Int Health, 2021, 26(10): 1256-1275. doi:10.1111/tmi.13648.
[34]	Njagi P, Arsenijevic J, Groot W. Understanding variations in catastrophic health expenditure, its underlying determinants and impoverishment in Sub-Saharan African countries: a scoping review. Syst Rev, 2018, 7(1): 136. doi:10.1186/s13643-018-0799-1. pmid: 30205846
[35]	王怡欢, 张楚. 农村贫困家庭灾难性卫生支出风险及影响因素研究——基于2018年CHARLS数据. 中国卫生政策研究, 2021, 14(1): 44-49. doi:10.3969/j.issn.1674-2982.2021.01.007.
[36]	Fuady A, Houweling T, Mansyur M, et al. Catastrophic total costs in tuberculosis-affected households and their determinants since Indonesia’s implementation of universal health coverage. Infect Dis Poverty, 2018, 7(1): 3. doi:10.1186/s40249-017-0382-3.
[37]	Laokri S, Dramaix-Wilmet M, Kassa F, et al. Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities. Trop Med Int Health, 2014, 19(10): 1249-1258. doi:10.1111/tmi.12365. pmid: 25040399
[38]	Wang Y, McNeil EB, Huang Z, et al. Household financial burden among multidrug-resistant tuberculosis patients in Guizhou province, China: A cross-sectional study. Medicine (Baltimore), 2020, 99(28): e21023. doi:10.1097/MD.0000000000021023.
[39]	Xu CH, Jeyashree K, Shewade HD, et al. Inequity in catastrophic costs among tuberculosis-affected households in China. Infect Dis Poverty, 2019, 8(1): 46. doi:10.1186/s40249-019-0564-2.
[40]	Chen S, Zhang H, Pan Y, et al. Are free anti-tuberculosis drugs enough? An empirical study from three cities in China. Infect Dis Poverty, 2015, 4: 47. doi:10.1186/s40249-015-0080-y. pmid: 26510711
[41]	Xu M, Markström U, Lyu J, et al. Detection of Low Adherence in Rural Tuberculosis Patients in China: Application of Morisky Medication Adherence Scale. Int J Environ Res Public Health, 2017, 14(3): 248. doi:10.3390/ijerph14030248.
[42]	Kaswa M, Minga G, Nkiere N, et al. The economic burden of TB-affected households in DR Congo. Int J Tuberc Lung Dis, 2021, 25(11): 923-932. doi:10.5588/ijtld.21.0182. pmid: 34686235
[43]	Tomeny EM, Mendoza VL, Marcelo DB, et al. Patient-cost survey for tuberculosis in the context of patient-pathway modelling. Int J Tuberc Lung Dis, 2020, 24(4): 420-427. doi:10.5588/ijtld.19.0206. pmid: 32317067
[44]	Ghazy RM, El SH, Abdulaziz S, et al. A systematic review and meta-analysis of the catastrophic costs incurred by tuberculosis patients. Sci Rep, 2022, 12(1):558. doi:10.1038/s41598-021-04345-x. pmid: 35017604
[45]	杨天池, 陈琴, 陈同, 等. 宁波市利福平耐药肺结核患者家庭灾难性医疗支出及其影响因素分析. 中国防痨杂志, 2019, 41(11): 1191-1196. doi:10.3969/j.issn.1000-6621.2019.11.009.
[46]	Arnold M, Beran D, Haghparast-Bidgoli H, et al. Coping with the economic burden of Diabetes, TB and co-prevalence: evidence from Bishkek, Kyrgyzstan. BMC Health Serv Res, 2016, 16: 118. doi:10.1186/s12913-016-1369-7. pmid: 27048370
[47]	马苑, 孙万里, 王训. 297例耐多药结核病患者经济负担影响因素分析. 贵州医药, 2022, 46(4): 595-596.
[48]	Brinda EM, Kowal P, Attermann J, et al. Health service use, out-of-pocket payments and catastrophic health expenditure among older people in India: The WHO Study on global AGEing and adult health (SAGE). J Epidemiol Community Health, 2015, 69(5): 489-494. doi:10.1136/jech-2014-204960.
[49]	Xiang L, Pan Y, Hou S, et al. The impact of the new coopera-tive medical scheme on financial burden of tuberculosis patients: evidence from six counties in China. Infect Dis Poverty, 2016, 5: 8. doi:10.1186/s40249-015-0094-5. pmid: 26818723
[50]	中华人民共和国国家统计局. 中华人民共和国2022年国民经济和社会发展统计公报. 北京: 中华人民共和国国家统计局, 2023.
[51]	王鉴, 黄成庆, 张云, 等. 不同医保类型患者住院费用和补偿水平的比较分析. 卫生经济研究, 2023, 40(10): 45-49. doi:10.14055/j.cnki.33-1056/f.2023.10.008.

国家/地区	人均GDP (美元)	发生率(%)					强度(%)					平均超支水平(%)
		预算分摊法			可支配收入法		预算分摊法			可支配收入法		预算分摊法			可支配收入法
		10	20	40	25	40	10	20	40	25	40	10	20	40	25	40
国外
埃塞俄比亚^[18]	750.60^a	40.00										6.30
巴基斯坦^[19]	1468.80^a					75.56					53.33					68.57
撒哈拉以南的非洲国家^[20]	1625.80^a	33.00				7.70
国内
重庆市^[21]	6551.90^b	52.80					18.10					34.20
山东省^[22]	8310.58^b		38.40
广东省^[23]	9241.16^b			70.15

类型	影响因素
患者因素	①性别;②年龄;③家庭收入与支出水平;④其他因素:教育水平、体质量指数、居住地、婚姻状况、就业状况等
疾病因素	①诊断延误或延误治疗;②特殊结核病
社会因素	医疗保险覆盖率;②医疗保险类别