Effect analysis on remission policy for TB treatment fee in Tilanqiao community of Shanghai / 上海预防医学

ABSTRACT

Objective To analyze the change in cost reduction for tuberculosis (TB) patients in Tilanqiao community of Shanghai from 2006 to 2016,and to evaluate the implement effect of TB remission policy in Shanghai.Methods The data were collected on treatment costs for 309 TB patients who had completed treatment and participated in the cost remission reimbursement by outpatient registration.The trend of deductible expenses and the remission costs were analyzed by SPSS.Results During the implementation of the original remission policy(ORP),the deductible expense was 1 021.06±457.67 yuan.And it changed to 2 320.64±1 544.73yuan under the new remission policy (NRP),which had an increase of 1.27 times and the new remission fee ratio was 45.19%.The deductible expenses change curve shown a trend of rising.The new remission fee ratio was 27.62% in 2009 and increased to 46.62% in 2010,then became 51.05% in 2016.The new remission fee ratio for outpatients was significantly lower than that for the hospitalized.During the implementation of the ORP,the remission cost was 931.05±465.47 yuan,and it was 1 507.80±974.15 of the NRP,which increased 61.95%.The remission ratio was 17.55% of the ORP,when it was 15.91% of the NRP which decreased by 1.64 percent.The remission ratio curve showed a trend of downward.The remission ratio for outpatients was significantly higher than that for the hospitalized.Conclusion From 2006 to 2016,the implement effect of remission policy on treatment costs of tuberculosis had improved.However,it had not effectively reduced the disease burden of TB patients.So in the follow-up remission policy,we must strengthen improvement on the settings of deductible project and control disease treatment.