The financial burden of tuberculosis-affected households in China, 2017

BackgroundDrug-susceptible pulmonary tuberculosis patients notified and treated under national tuberculosis program, ChinaMethodsWe conducted a cross-sectional study in six provinces in 2017 to assess the burden and distribution of health expenditure costs among tuberculosis-affected households and analyze related risk factors. The data was collected through face-to-face questionnaire survey. Intensity of financial burden was the median positive overshoot beyond a threshold that defined as annual total (direct and indirect) costs exceeding 20% of the pre-TB annual household income.ResultsOf 1147 patients, median (interquartile range) total costs due to tuberculosis care were US$965.5(461.8, 2059.3). Costs due to pre-treatment care accounted for 46.3% and direct costs accounted for 82.5% for total costs. Median (interquartile range) intensity of catastrophic costs was 32%(11%, 88%). Living below poverty line, household size less than four, employment in informal sector, receiving treatment from tuberculosis dispensary and hospitalization were independent predictors of associated with higher financial burden.ConclusionDespite free tuberculosis care services, the health expenditure due to tuberculosis were high among tuberculosis-affected households.Trial registrationThe Ethics Committee of Chinese Center of Disease Control and Prevention approved the study (No.201625, dated 22 November 2016).