What causes high costs for rural tuberculosis inpatients? Evidence from five counties in China

Abstract

Background: Tuberculosis (TB) still causes high economic burden on patients in China, especially for rural patients. Our study aims to explore the risk factors associated with the high costs for TB inpatients in rural China from the aspects of inpatients' socio-demographic and institutional attributes. Methods: Generalized linear models were utilized to investigate the factors associated with TB inpatients' total costs and out-of-pocket (OOP) expenditures. Quantile regression (QR) models were applied to explore the effect of each factor across the different costs range and identify the risk factors of high costs. Results: TB inpatients with long length of stay and who receive hospitalization services cross provincially, in tertiary and specialized hospitals were likely to face high total costs and OOP expenditures. QR models showed that high total costs occurred in Dingyuan and Funan Counties, but they were not accompanied by high OOP expenditures. Conclusions: Early diagnosis, standard treatment and control of drug-resistant TB are still awaiting for more efforts from the government. TB inpatients should obtain medical services from appropriate hospitals. The diagnosis and treatment process of TB should be standardized across all designated medical institutions. Furthermore, the reimbursement policy for migrant workers who suffered from TB should be ameliorated.

Establishment and evaluation of an overlap extension polymerase chain reaction technique for rapid and efficient detection of drug-resistance in Mycobacterium tuberculosis

“…In addition, the method based on culture requires trained personnel and high biosafety-level laboratories for the assurance of personal safety. Comparatively, genotypic drug-resistance detection techniques, including realtime fluorescent PCR testing [4], GeneXpert MTB/RIF [5], linear probe hybridization [6], DNA microarray technology [7] and gene chip (biochip) technology [8], have facilitated the rapid diagnosis of TB and also the detection of anti-tuberculous drug resistance to some extent; however, the relatively high cost, complexity of use, and the restricted accessibility associated with these techniques have limited their widespread application in general clinical practice [9][10][11]. The GeneXpert MTB/RIF test can rapidly identify M. tuberculosis bacilli and simultaneously detect drug resistance; nevertheless, it is limited to rifampicin resistance only [5].…”