Summary of Talk:
Tuberculosis is a major public health concern in China with over 5 million patients. Financial burden associated with out of pocket payment for TB services has been one of major obstacles in the effective implementation of TB care and control strategies in China. This issue largely resulted from a rapid rise of TB care cost that were associated with the over-provision of services by the Chinese hospitals, such as over-use of the second-line anti-TB medications, induced hospitalization, as the hospitals had been given perverse financial incentives. To address these issues and encourage appropriate TB treatment, China NHFPC-Gates TB program, in collaboration with the health insurance programs, had implemented an innovative financing and payment scheme in 26 counties of 3 provinces in China over the past three years. An evaluation was carried out to assess the program impact on patients’ service utilization, financial burden and medication adherence. Two surveys of 798 patients at the baseline and endpoint showed that the program had improved TB patients’ utilization of outpatient services and medication adherence, which had positive impact on treatment outcome. However, inpatient service utilization did not decrease. The evaluation did not find any evidence of reduced financial burden related to TB service expenses incurred on patients.
Dr DONG Di received her PhD in Health Economics from the Duke-National University of Singapore Graduate Medical School, and is currently a post-doc research fellow in Duke-Kunshan University. Her research areas include China health care reform and health policies, health insurance, public health program evaluation, and health technology assessment in the area of precision medicine. She had experiences working with the Gates Foundation, China CDC, China Health and Family Planning Commission, China State Council Development Research Center, and Singapore Health Sciences Authority on various health economics and policy issues.