Catastrophic health expenditure among migrants with tuberculosis in Putuo District, Shanghai

Objective To study catastrophic health expenditure among migrants with tuberculosis for completion of policy system and improvement of patient compliance with treatment in Putuo District, Shanghai.Methods A retrospective study was conducted to acquire the information about the newly registered domestic migrant patients with completed treatment in 2008 and their family situation that resulted from tuberculosis treatment.Results For the 97 patients included, the proportions of direct medical cost, direct cost and total cost for tuberculosis treatment to patients' capacity to pay were 11.02%, 15.60% and 23.06% while they fell to 4.97%, 6.13% and 12.27% due to the relief policy of the government. There were 15.46%, 23.71% and 34.02% families of target patients that encountered catastrophic health expenditure because of direct medical cost, direct cost and total cost for tuberculosis treatment and the proportions were reduced to 8.25%, 15.46% and 25.77% with the help of the relief policy. The mean catastrophic expenditure gaps were reduced from 10.12%, 15.03% and 24.76% to 8.23%, 12.28% and 21.33% respectively, and the mean positive gap were from 65.47%, 63.39% and 72.79% down to 53.20%, 51.78% and 62.70% owing to the policy.Conclusion There were not many target families found to have suffered from catastrophic effect caused by tuberculosis treatment but some families still should be concerned about in this regard. Better relief policy should be explored to protect the families from economic risk of the disease.