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Publications

Filtering by Tag: Qian Long

Drug-resistant tuberculosis control in China: progress and challenges

Future Health Systems

Long Q, Qu Y, and Lucas H (2016) Drug-resistant tuberculosis control in China: progress and challenges, Infect Dis Poverty. 2016; 5: 9. doi: 10.1186/s40249-016-0103-3

Abstract

Background: China has the second highest caseload of multidrug-resistant tuberculosis (MDR-TB) in the world. In 2009, the Chinese government agreed to draw up a plan for MDR-TB prevention and control in the context of a comprehensive health system reform launched in the same year.

Discussion: China is facing high prevalence rates of drug-resistant TB and MDR-TB. MDR-TB disproportionally affects the poor rural population and the highest rates are in less developed regions largely due to interrupted and/or inappropriate TB treatment. Most households with an affected member suffer a heavy financial burden because of a combination of treatment and other related costs. The influential Global Fund programme for MDR-TB control in China provides technical and financial support for MDR-TB diagnosis and treatment. However, this programme has a fixed timeline and cannot provide a long term solution. In 2009, the Bill and Melinda Gates Foundation, in cooperation with the National Health and Family Planning Commission of China, started to develop innovative approaches to TB/MDR-TB management and case-based payment mechanisms for treatment, alongside increased health insurance benefits for patients, in order to contain medical costs and reduce financial barriers to treatment. Although these efforts appear to be in the right direction, they may not be sufficient unless (a) domestic sources are mobilized to raise funding for TB/MDR-TB prevention and control and (b) appropriate incentives are given to both health facilities and their care providers.

Summary: Along with the on-going Chinese health system reform, sustained government financing and social health protection schemes will be critical to ensure universal access to appropriate TB treatment in order to reduce risk of developing MDR-TB and systematic MDR-TB treatment and management.

Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China

Future Health Systems

Zhou C, Long Q, Chen J, Xiang L, Li Q, Tang S, Huang F, Sun Q, and Lucas H (2016) Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China, Infect Dis Poverty. 2016; 5: 6. doi:  10.1186/s40249-016-0100-6

Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households. A number of studies have analyzed patient and household expenditure on TB care, but there does not appear to be any that have assessed the incidence, intensity and determinants of catastrophic health expenditure (CHE) relating to TB care in China. That will be the objective of this paper.

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Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China

Future Health Systems

Li Q, Jiang W, Wang Q, Shen Y, Gao J, Sato KD, Long Q, and Lucas H (2016) Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China, Infect Dis Poverty. 2016; 5: 5. doi:  10.1186/s40249-016-0101-5

Treatment of tuberculosis (TB) in China is partially covered by national programs and health insurance schemes, though TB patients often face considerable medical expenditures. For some, especially those from poorer households, non-medical costs, such as transport, accommodation, and nutritional supplementation may be a substantial additional burden. In this article the authors aim to evaluate these non-medical costs induced by seeking TB care using data from a large scale cross-sectional survey.

 

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Are free anti-tuberculosis drugs enough? An empirical study from three cities in China

Future Health Systems

Chen S, Zhang H, Pan Y, Long Q, Xiang L, Yao L and Lucas H (2015) Are free anti-tuberculosis drugs enough? An empirical study from three cities in China, Infectious Diseases of Poverty, 4:47, doi:10.1186/s40249-015-0080-y

Tuberculosis (TB) patients in China still face a number of barriers in seeking diagnosis and treatment. There is evidence that the economic burden on TB patients and their households discourages treatment compliance.  Data were collected using a questionnaire survey, key informant interviews and focus group discussions with TB patients to gain an understanding of the economic burden of TB and implications of this burden for treatment compliance.

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