DISPARITIES IN “CATASTROPHIC” OUT-OF-POCKET COST INCURRED FROM MULTI-DRUG RESISTANT TUBERCULOSIS TREATMENT AMONG MIGRANT AND RESIDENT PATIENTS IN GUANGZHOU, GUANGDONG PROVINCE, PR CHINA

Authors

  • Jiali Ye
  • Xia Zou
  • Huizhong Wu Center for Tuberculosis Control of Guangdong Province
  • Liang Chen
  • Fangjing Zhou Center for Tuberculosis Control of Guangdong Province
  • Hui Zhang Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University
  • Haobin Kuang
  • Cheng Gong
  • Lin Zhou Center for Tuberculosis Control of Guangdong Province
  • Ling Li Sun Yat-sen University

Keywords:

China, migrant, multidrug-resistant tuberculosis, resident, “catastrophic” cost, out-of-pocket cost

Abstract

Out-of-pocket (OOP) costs of multidrug-resistant tuberculosis (MDR-TB) treatment before and after reimbursement of resident and migrant patients (n = 162) were estimated using hierarchical multiple logistic regression models. Total OOP cost of migrant and resident patients was USD 15,138 (interquartile range (IQR) = USD 9,646-20,199) and USD 3,871 (IQR = 2,584-7,637) respectively, with 46 and 90% suffering from ruinous cost respectively (p-value<0.01). Low annual household income (adjusted odds ratio (adjusted OR) = 17.30, 95% confidence interval (CI): 4.93-60.78) and loss of employment (adjusted OR = 4.14, 95% CI: 1.46-11.76) increased risk of incurring “catastrophic” MDR-TB treatment cost. As expected reimbursement program contributed to reduction in OOP cost of a larger proportion of resident compared to migrant patients. These findings indicate increasing reimbursement of MDR-TB treatment to both low-income migrant and resident patients will mitigate “catastrophic cost”, and more reimbursement should be given to migrant patients.

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Published

2021-06-21 — Updated on 2022-01-20

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