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

Infectious Diseases of Poverty 2015年第1期4卷 389-398页

作者： Shanquan Chen Hui Zhang Yao Pan Qian Long Li Xiang Lan Yao Henry Lucas The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong KongChina National Center for TB Control and Prevention China CDCBeijingPR China The Third Affiliated Hospital Sun Yat-sen UniversityGuangzhouChina Duke Global Health Institute Duke UniversityDurhamNCUSA Global Health Research Center Duke Kunshan UniversityKunshanChina School of Medicine and Health Management Huazhong University of Science and TechnologyWuhanChina Institute of Development Studies Sussex UniversityBrightonUK Chinese Center for Disease Control and Prevention BeijingPR China

Background:Tuberculosis(TB)patients in China still face a number of barriers in seeking diagnosis and *** is evidence that the economic burden on TB patients and their households discourages treatment ***:A cross-sectional study was conducted in three cities of *** were selected using probability proportional to size(PPS)cluster sampling of rural townships or urban streets,followed by list sampling from a patient *** 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 ***:A total of 797 TB patients were surveyed,of which 60 were interviewed in-depth following the *** than half had catastrophic health *** patients with higher household incomes were less likely to report non-compliance(OR 0.355,95%CI 0.140–0.830)and patients who felt that the economic burden relating to TB treatment was high more likely to report non-compliance(OR 3.650,95%CI 1.278–12.346).Those who had high costs for transportation,lodging and food were also more likely to report non-compliance(OR 4.150,95%CI 1.804–21.999).The findings from the qualitative studies supported those from the ***:The economic burden associated with seeking diagnosis and treatment remains a barrier for TB patients in *** the cost of treatment and giving patients subsidies for transportation,lodging and food is likely to improve treatment *** doctors’salary system to cut off the revenue-oriented incentive,and expanding current insurance’s coverage can be helpful to reduce patients’actual burden or anticipated *** research on this issue is needed.

关键词： Tuberculosis Economic burden catastrophic expenditure Compliance China

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Assessing the Impact of Health Insurance on Household Financial Protection in Togo

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Health 2023年第6期15卷 507-516页

作者： Aboubakar Issa Yaovi Tossou Kodjo Evlo Département d’Politique et Système de Santé Institut Régional de Santé Publique Ouidah Bénin Programme Couverture Sanitaire Universelle Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Direction des études de la Planification et de la Programmation Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Département d’Economie Faculté des Sciences économiques et de Gestion Université de Lomé Lomé Togo

Context: To facilitate financial access to care for the population, health insurance mechanisms have been established, in particular the National Health Insurance Institute, which covers civil servants and their dependents. In addition, other voluntary and community mechanisms have been developed. After several years of implementation, the level of catastrophic health expenditures among insured individuals shows that there is still a considerable level of financial risk associated with health care. This study aims to assess the impact of health insurance in Togo on insured populations. Methodology: The data used in this study come from the harmonized survey on household living conditions carried out in 2018 by the National Institute of Statistics, Economic and Demographic Studies. The propensity score matching method was used according to the following steps: estimation of propensity scores, verification of the conditional independence hypothesis (balancing property) and estimation of the average treatment effect on treated. Stata V14.2 software was used. Findings: The average effect of health insurance on household financial protection is −0.012 for the nearest neighbor method, −0.013 for the matching radius method, −0.015 for the Kernel and −0.016 for the stratification method. Results showed that health insurance contributes to reducing catastrophic health expenditures, but their effect remains very limited. This could be explained by the level of care package covered and the cost covered. Conclusion: Health insurance contributes to the reduction of catastrophic health expenses for households. However, it is important to widen the range of care covered and the cost covered. In addition, measures to extend this coverage to a larger proportion of the population will make it possible to have a greater impact.

关键词： Impact Health Insurance catastrophic expenditure

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