Abstract: Objective  To analyze the medical expense and the family economic burden of new smear positive pulmonary tuberculosis cases in TB designated  hospitals.  Methods  Four TB designated hospitals in 4 cities were selected, and 106 new smear positive patients in these hospital before August 2009  were investigated by questionnaire and medical record review. Information about the social economic conditions and medical expenses was collected. Descriptive analysis was done for patients’ social economic conditions and medical expenses.  Results  The median of the medical expense of the new smear positive patients in 4 designated hospitals is 11 282 RMB. 90.8%（69/76）patients have a catastrophic expenditure. The economic burden decreased after the reimbursement of the people with health insurance, but 68.4%（52/76）patients still have a catastrophic health expenditure. The percentage of people who were in debt caused by TB is 47.2%（50/106）.Among them, 76.0%（38/50）have not yet pay off their debt by the investigation day. 58.5%（62/106）new smear positive pulmonary tuberculosis patients feel a heavy economic burden.  Conclusion  The medical expense of new smear positive patients in designated hospital is high, leading to the catastrophic health expenditures for their family.

Key words: Tuberculosis, pulmonary/economics, Inpatients, Fees,medical