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Improving Access to and Affordability of Healthcare for TB Patients in China

Edited by: Prof. Shenglan Tang

China is the country with the second largest burden of both tuberculosis (TB), and multi-drug resistant tuberculosis (MDR-TB) in the world. China Center for Disease Control and Prevention (CDC), under the auspice of the Chinese National Health and Family Planning Commission and with the support from the Bill and Melinda Gates Foundation, has been developing and implementing an innovative program on TB and MDR-TB care and control in a number of Chinese provinces to improve access to, and affordability for, quality TB care. One major challenge in tackling TB epidemic in China is how TB services can be effectively financed and delivered under the context of the on-going health system reform.

Three project cities (Zhenjiang of Jiangsu Province, Yichang of Hubei Province and Hanzhong of Shaanxi Province were selected to implement interventions related to the application of new diagnosis and treatment approaches and new financial mechanisms for TB care in 2013/14. These papers published in this special issue used the data from the survey carried out in early 2013 to understand current practice in financing TB/MDR-TB care in the three project cities and implications for equity, efficiency and effectiveness in relation to the provision, accessibility and utilization of TB/MDR-TB related services. It was also intended to generate baseline data that can be used to compare TB/MDR-TB care before and after the policy interventions and evaluate their effects/impacts at the end of project completion.

Researchers from three Chinese universities in Nanjing, Xi’an and Wuhan), with the support from Duke University/Duke Kunshan University, and China CDC, have carried out the data collection and analyses. This special issue is the collection of main papers presenting key findings on access to/use of TB care, and particularly financial affordability of healthcare, as well as impacts of the Chinese health insurance schemes on financial protections in care seeking for the TB patients in China.

  1. Tuberculosis (TB) prevalence is closely associated with poverty in China, and poor patients face more barriers to treatment. Using an insurance-based approach, the China-Gates TB program Phase II was implement...

    Authors: Di Dong, Wei-Xi Jiang, Qian Long, Fei Huang, Hui Zhang, Jia-Ying Chen, Li Xiang, Qiang Li, Sheng-Lan Tang and Henry Lucas
    Citation: Infectious Diseases of Poverty 2019 8:44
  2. In response to the high financial burden of health services facing tuberculosis (TB) patients in China, the China-Gates TB project, Phase II, has implemented a new financing and payment model as an important c...

    Authors: Wei-Xi Jiang, Qian Long, Henry Lucas, Di Dong, Jia-Ying Chen, Li Xiang, Qiang Li, Fei Huang, Hong Wang, Chris Elbers, Frank Cobelens and Sheng-Lan Tang
    Citation: Infectious Diseases of Poverty 2019 8:21
  3. This paper introduces the background, aim and objectives of the project entitled “China—the Gates Foundation Collaboration on TB Control in China” that has been underway for many years. It also summarizes the ...

    Authors: Shenglan Tang, Lixia Wang, Hong Wang and Daniel P. Chin
    Citation: Infectious Diseases of Poverty 2016 5:10
  4. Tuberculosis (TB) patients in China encounter heavy financial burdens throughout the course of their treatment and it is unclear how China’s health insurance systems affect the alleviation of this burden under...

    Authors: Li Xiang, Yao Pan, Shuangyi Hou, Hongwei Zhang, Kaori D. Sato, Qiang Li, Jing Wang and Shenglan Tang
    Citation: Infectious Diseases of Poverty 2016 5:8
  5. Health inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urb...

    Authors: Yao Pan, Shanquan Chen, Manli Chen, Pei Zhang, Qian Long, Li Xiang and Henry Lucas
    Citation: Infectious Diseases of Poverty 2016 5:7
  6. Treatment of tuberculosis (TB) in China is partially covered by national programs and health insurance schemes, though TB patients often face considerable medical expenditures. For some, especially those from ...

    Authors: Qiang Li, Weixi Jiang, Quanli Wang, Yuan Shen, Jingyuan Gao, Kaori D. Sato, Qian Long and Henry Lucas
    Citation: Infectious Diseases of Poverty 2016 5:5
  7. Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households. A number of studies have analyzed patient and household expenditure on TB care, b...

    Authors: Chengchao Zhou, Qian Long, Jiaying Chen, Li Xiang, Qiang Li, Shenglan Tang, Fei Huang, Qiang Sun and Henry Lucas
    Citation: Infectious Diseases of Poverty 2016 5:6
  8. In the 1990s, China introduced a “free” tuberculosis (TB) care policy under the national TB control program. Recently, as a part of a new TB diagnosis and treatment model, it has been recommended that the inte...

    Authors: Xinxin Jia, Jiaying Chen, Siyuan Zhang, Bing Dai, Qian Long and Shenglan Tang
    Citation: Infectious Diseases of Poverty 2016 5:1
  9. China’s national tuberculosis control program (NTP) provides free, first-line anti-tuberculosis (TB) drugs to pulmonary TB patients. This treatment regimen follows the World Health Organization’s (WHO) guideli...

    Authors: Fei Huang, Hui Zhang, Qing Lv, Kaori D. Sato, Yan Qu, Shitong Huan, Jun Cheng, Fei Zhao and Lixia Wang
    Citation: Infectious Diseases of Poverty 2016 5:2
  10. China has recently adopted the “TB designated hospital model” to improve the quality of tuberculosis (TB) treatment and patient management. Considering that inpatient service often results in high patient fina...

    Authors: Hongyan Hu, Jiaying Chen, Kaori D. Sato, Yang Zhou, Hui Jiang, Pingbo Wu and Hong Wang
    Citation: Infectious Diseases of Poverty 2016 5:4
  11. Tuberculosis (TB) patients in China still face a number of barriers in seeking diagnosis and treatment. There is evidence that the economic burden on TB patients and their households discourages treatment comp...

    Authors: Shanquan Chen, Hui Zhang, Yao Pan, Qian Long, Li Xiang, Lan Yao and Henry Lucas
    Citation: Infectious Diseases of Poverty 2015 4:47