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| 1 | Impact of an innovative financing and payment model on tuberculosis patients'financial burden:is tuberculosis care more affordable for the poor?显示文摘Background:In response to the high financial burden of health services facing tuberculosis(TB)patients in China,the China-Gates TB project,PhaseⅡ,has implemented a new financing and payment model as an important component of the overall project in three cities in eastern,central and western China.The model focuses on increasing the reimbursement rate for TB patients and reforming provider payment methods by replacing fee-for-service with a case-based payment approach.This study investigated changes in out-of-pocket(OOP)health expenditure and the financial burden on TB patients before and after the interventions,with a focus on potential differential impacts on patients from different income groups.Methods:Three sample counties in each of the three prefectures:Zhenjiang,Yichang and Hanzhong were chosen as study sites.TB patients who started and completed treatment before,and during the intervention period,were randomly sampled and surveyed at the baseline in 2013 and final evaluation in 2015 respectively.OOP health expenditure and percentage of patients incurring catastrophic health expenditure(CHE)were calculated for different income groups.OLS regression and Iogit regression were conducted to explore the intervention's impacts on patient OOP health expenditure and financial burden after adjusting for other covariates.Key-informant interviews and focus group discussions were conducted to understand the reasons for any observed changes.Results:Data from 738(baseline)and 735(evaluation)patients were available for analysis.Patient mean OOP health expenditure increased from RMB 3576 to RMB 5791,and the percentage of patients incurring CHE also increased after intervention.The percentage increase in OOP health expenditure and the likelihood of incurring CHE were significantly lower for patients from the highest income group as compared to the lowest.Qualitative findings indicated that increased use of health services not covered by the standard package of the model was likely to have caused the increase in financial burden.Conclusions:The implementation of the new financing and payment model did not protect patients,especially those from the lowest income group,from financial difficulty,due partly to their increased use of health service.More financial resources should be mobilized to increase financial protection,particularly for poor patients,while cost containment strategies need to be developed and effectively implemented to improve the effective coverage of essential healthcare in China. | Wei-Xi Jiang Qian Long Henry Lucas Di Dong Jia-Ying Chen Li Xiang Qiang Li Fei Huang Hong Wang Chris Elbers Frank Cobelens Sheng-Lan Tang | 2019 | Infectious Diseases of Poverty2019，8，2： | 4 |
| 2 | Predictive value for progression to tuberculosis by IGRA and TST in immigrant contacts 显示文摘 | Kik SV Franken WP Mensen M Cobelens FG Kamphorst M Arend SM Erkens C Gebhard A Borgdorff MW Verver S | 2010 | Eur Respir J2010，35，6： | 1 |
| 3 | Interferon- beta attenuates lung inflammation following experimental sub- arachnoid hemorrhage显示文摘 | Cobelens PM Tiebosch IA Dijkhuizen RM | 2010 | Critical Care2010，14，4： | 1 |
| 4 | Diarrheagenic Escherichia Coli and acute and persistent diarrhea in returned travellers 显示文摘 | Schuhs C Van Den Ende Cobelens F | 2000 | J Clin Microbio2000，38，10： | 1 |
| 5 | Treatment outcomes by drug resistance and HIV status among tuberculosis patients in Ho Chi Minh City,Vietnam显示文摘 | Quy HT Cobelens FG Lan NT | 2006 | Int J Tuberc Lung Dis2006，10，： | 1 |
| 6 | 显示文摘 | Berkel GM Cobelens FG de Vries G | 2005 | Int J Tuberc Lung Dis2005，9，3： | 1 |
| 7 | Tuberculosis drug resis- tance and HIV infection, the netherlands 显示文摘 | Catharina HH Frank GJ Cobelens | 2007 | Emerg Infect Dis2007，13，5： | 1 |
| 8 | Inflammatory Consequences of lung ischemia-reperfusion injury and low-pressure ventilation显示文摘 | Cobelens PM van Putte BP Kavelaars A | 2009 | J Surg Res2009，153，2： | 1 |
| 9 | Inflammatory Consequences of lung ischemia Reperfusion injury and low-Pressure Ventilation显示文摘 | COBELENS P M | | 0，，： | 1 |
| 10 | Inflammatory conse- quences of lung ischemia-reperfusion injury and low-pressure ventila- tion显示文摘 | Cobelens PM van Putte BP Kavelaars A | 2009 | J Surg Res2009，153，2： | 1 |
| 11 | Exogenous surfactant attenuation of ischemia-reperfusion injury in the lung through alteration of inflammatory and apoptotic factors 显示文摘 | van Putte BP Cobelens PM van der Kaaij N | 2009 | J Thorac Cardiovasc Surg2009，137，4： | 1 |
| 12 | Exogenous surfactant attenuation of ischemia-reperfusion injury in the lung through alteration of inflammatory and apoptotic factors 显示文摘 | van Putte BP Cobelens PM van der Kaaij N | 2009 | J Thorac Cardiovasc Surg2009，137，4： | 1 |
| 13 | Disturbed in vitro adrenergic modulation of cytokine production in inflammatory bowel diseases in remission显示文摘 | A. Lucas P.M. Cobelens A. Kavelaars C.J. Heijnen G. Holtmann S. Haag G. Gerken J. Langhorst G.J. Dobos M. Schedlowski S. Elsenbruch | 2005 | Journal of Neuroimmunology2005，，1： | 1 |
| 14 | Diarrheagenic Escherichia coil and acute and persistent diarrhea in returned travelers 显示文摘 | Schultsz C van den Ende J Cobelens F | 2000 | J Clin Microbiol2000，38，10： | 1 |
| 15 | Inflammatory consequences of lung ischemia-reperfusion injury and low-pressure ventilation显示文摘 | Cobelens PM Van Putte BP Kavelaars A | 2008 | J Surg Res2008，153，2： | 1 |
| 16 | Inflamma- tory consequences of lung ischemia - reperfusion injury and low - pressure ventilation显示文摘 | COBELENS P M PUTFE B P KAVELAARS A | 2009 | J Surg Res2009，153，2： | 1 |
| 17 | In- flammatory consequences of lung ischemia- reperfusion injury and low-Pressure ventilation 显示文摘 | Cobelens M van Putte P Kavelaars A | 2009 | J Surg Res2009，153，2： | 1 |
| 18 | Inflammatory consequences of lung ischemia-reperfusion injury and low- pressure ventilation 显示文摘 | Cobelens PM van Putte BP Kavelaars A | 2009 | J Surg Res2009，153，2： | 1 |
| 19 | Scaling up programmatic management of drug-resistant tuberculosis:a prioritized research agenda显示文摘 | Cobelens FG Heldal E Kimerling ME | 2008 | PLoS Med2008，5，7： | 1 |
| 20 | Association of tuberculin sensitivity in Dutch adults with history of travel to areas of with a high incidence of tuberculosis 显示文摘 | Cobelens FG Van Deutekom H Draayer- Jansen IW | 2001 | ClinlnfectDis2001，33，3： | 1 |
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