title: Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China.
abstract: METHODS
  A county in Jiangsu Province, China.
  
  
  OBJECTIVE
  To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden.
  
  
  METHODS
  In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses.
  
  
  RESULTS
  The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay.
  
  
  CONCLUSIONS
  Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.
authors.affiliation: Department of Tuberculosis, Third Hospital of Zhenjiang City, Zhenjiang, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: H-Q
authors.initials: HQ
authors.lastname: Pan
authors.forename: S
authors.initials: S
authors.lastname: Bele
authors.forename: Y
authors.initials: Y
authors.lastname: Feng
authors.forename: S-S
authors.initials: SS
authors.lastname: Qiu
authors.forename: J-Q
authors.initials: JQ
authors.lastname: Lü
authors.forename: S-W
authors.initials: SW
authors.lastname: Tang
authors.forename: H-B
authors.initials: HB
authors.lastname: Shen
authors.forename: J-M
authors.initials: JM
authors.lastname: Wang
authors.forename: L-M
authors.initials: LM
authors.lastname: Zhu
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D002681:China; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D005102:Health Expenditures; D017721:Hospital Costs; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D019035:Rural Health Services / Q000191:economics*; D018582:Sick Leave / Q000191:economics; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents