Inequity in catastrophic costs among tuberculosis-affected households in China

Autor: Cai-Hong Xu, Kathiresan Jeyashree, Hemant Deepak Shewade, Yin-Yin Xia, Li-Xia Wang, Yan Liu, Hui Zhang, Li Wang
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Infectious Diseases of Poverty, Vol 8, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 2049-9957
DOI: 10.1186/s40249-019-0564-2
Popis: Abstract Background There are limited nationally representative studies globally in the post-2015 END tuberculosis (TB) era regarding wealth related inequity in the distribution of catastrophic costs due to TB care. Under the Chinese national tuberculosis programme setting, we aimed to assess extent of equity in distribution of total TB care costs (pre-treatment, treatment and overall) and costs as a proportion of annual household income (AHI), and describe and compare equity in distribution of catastrophic costs (pre-treatment, treatment and overall) across population sub-groups. Methods Analytical cross-sectional study using data from national TB patient cost survey carried out in 22 counties from six provinces in China in 2017. Drug-susceptible pulmonary TB registered under programme, who had received at least 2 weeks of intensive phase therapy were included. Equity was depicted using concentration curves and concentration indices were compared using dominance test. Results Of 1147 patients, the median cost of pre-treatment, treatment and overall care, were USD 283.5, USD 413.1 and USD 965.5, respectively. Richer quintiles incurred significantly higher pre-treatment and treatment costs compared to poorer quintiles. The distribution of costs as a proportion of AHI and catastrophic costs were significantly pro-poor overall as well as during pre-treatment and treatment phase. All the concentration curves for catastrophic costs (due to pre-treatment, treatment and overall care) stratified by region (east, middle and west), area of residence (urban, rural) and type of insurance (new rural co-operative medical system [NCMS], non-NCMS) also exhibited a pro-poor pattern with statistically significant (P
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