Evaluation of the effect of the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment.

IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES
Xing-Yu Hu, Guang-Ying Gao
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引用次数: 3

Abstract

Background: PTB is an infectious disease, which not only seriously affects people's health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries.

Methods: The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes.

Results: After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%.

Conclusions: The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.

Abstract Image

Abstract Image

肺结核患者全期治疗人头补偿机制的效果评价。
背景:肺结核是一种传染性疾病,不仅严重影响人们的健康,而且给患者造成了较重的疾病经济负担。目前,医疗保险支付改革是控制医疗费用的有效手段。因此,我们的研究旨在探索肺结核(PTB)患者全期治疗的补偿机制,减轻PTB患者的经济负担,为其他地区和国家的PTB支付方式改革提供参考和依据。方法:收集吉林省德惠市结核病医院2015年上半年至2018年上半年肺结核患者的定量数据,随机抽取该院2018年上半年登记的肺结核患者病历(n = 100)。描述性分析这些定量数据总结了数量、费用、用药和依从性。对政策制定者和医生进行了半结构化的深度访谈,以了解干预措施的影响及其原因。结果:实施补偿机制后,2018年PTB患者就诊人次增加14.2%,门诊和住院患者平均医疗费用分别显著下降31.8%和47.0%,辅助用药费用下降36.5%。此外,医院对结核病进行了规范化管理,患者的依从性非常高,几乎达到90%。结论:全治疗期人头补偿机制是一种适合肺结核患者的支付方式,值得推广和试验。此外,该模型提高了患者的依从性,降低了耐药肺结核的可能性。但由于该模式在试点地区实施时间较短,效果有待进一步观察论证。
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health
CiteScore
16.70
自引率
1.20%
发文量
368
审稿时长
13 weeks
期刊介绍: Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.
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