Effect analysis on remission policy for TB treatment fee in Tilanqiao community of Shanghai

ObjectiveTo analyze the change in cost remission for tuberculosis (TB) patients in Tilanqiao community of Shanghai from 2006 to 2016, and to evaluate the implementation effect of TB remission policy in Shanghai.

MethodsThe data were collected on treatment costs for 309 TB patients who had completed treatment and participated in the cost remission reimbursement by outpatient registration. The trend of deductible expenses and the remission costs were analyzed by SPSS.

ResultsDuring the implementation of the original remission policy(ORP), the deductible expense was 1 021.06±457.67 yuan. And it changed to 2 320.64±1 544.73 yuan under the new remission policy (NRP), which had an increase of 1.27 times and the new remission fee ratio was 45.19%. The deductible expenses change curve shown a trend of rising. The new remission fee ratio was 27.62% in 2009 and increased to 46.62% in 2010, then became 51.05% in 2016. The new remission fee ratio for outpatients was significantly lower than that for the hospitalized. During the implementation of the ORP, the remission cost was 931.05±465.47 yuan, and it was 1 507.80±974.15 of the NRP, which increased 61.95%. The remission ratio was 17.55% of the ORP, when it was 15.91% of the NRP which decreased by 1.64 percent. The remission ratio curve showed a trend of downward. The remission ratio for outpatients was significantly higher than that for the hospitalized.

ConclusionFrom 2006 to 2016, the implementation effect of remission policy on treatment costs of tuberculosis had improved. However, as far as the patients were concerned, it had not much reduced the disease burden of TB patients on the whole. So in the follow-up remission policy, we must increase settings of deductible projects and control disease treatment regimen.