Objective To understand the self-paid medical expenses of drug-resistant tuberculosis (TB) patients in Beijing and indentify influencing factors.

Methods A cross-sectional survey design was used for this study. The new rifampicin resistant TB patients who were successfully treated in Beijing from January 2021 to December 2023 were included. The patients' sociodemographic information and medical expense information were collected, and a multiple linear regression model was used to analyze the influencing factors of self-paid medical expense.

Results A total of 158 drug-resistant TB patients were included in this study, and the median of age of the patients was 38.5 years. The patients were mainly staff (36 cases, 22.78%), and 87.34%（138 cases）of the patients had healthcare insurance. The median of annual household income of the patients was 100000.00 (55000.00, 17000.00) yuan. The average self-paid medical expenses of the patients were 59367.61 yuan, the median was 42280.95 (23795.73, 76037.60) yuan. The median proportion of self-paid outpatient expenses was 80.90% (64.95%, 100.00%), and the median proportion of self-paid hospitalization expenses was 28.56% (19.66%, 45.60%). The results of multivariate analysis showed that age, medical insurance, free second-line anti-TB drug treatment, hospitalization, bedaquiline use and the duration of treatment were influencing factors of self-paid medical expenses of drug resistant TB patients (P<0.05).

Conclusion The implementation of drug-resistant TB treatment policies of Beijing has benefited the reduction of the medical expenses of the patients, but the medical expenses of some drug resistant TB patients are still high. New policies should be developed and new measures should be taken according to the current incidence or prevalence of TB and the actual medical needs of patients to further reduce the economic burden of drug resistant TB patients.