Analysis on catastrophic total costs in families with pulmonary tuberculosis patients and influencing factors in minority ethnic groups in Guizhou, 2020

Objective To understand the current status of catastrophic total costs(CTC) in families with pulmonary tuberculosis (TB) patients and influencing factors in minority ethnic groups in Guizhou province, and provide evidence for further reducing the economic burden of patients' families.

Methods A face-to-face questionnaire survey was conducted in pulmonary TB patients selected through probability proportional sampling in minority ethnic groups in 88 counties and districts in Guizhou, who were registered for treatment and management from May to June 2020 and had completed the course of treatment and/or been cured at the time of the survey. CTC was described by using rate analysis, and influencing factors were analyzed with χ² test and logistic regression model.

Results A total of 1013 pulmonary TB patients were included in this study, the average total self-paid medical expenditure was 10210.00 yuan. The median (quartiles) of the total cost before and after diagnosis were 1150.01 yuan (0.00, 5000.03), which were mainly direct medical expenditure, and 6696.32 yuan (3689.62, 1141.63), which were mainly indirect medical expenditure, respectively. The incidence of CTC in the patients' families was 50.44%. Age, educational level, annual family income, comorbidity of chronic diseases, patient classification, and hospitalization were influencing factors for the incidence of CTC in families of the pulmonary TB patients (all P<0.05).

Conclusion The incidence of CTC in the pulmonary TB patient's family was relatively high in minority ethnic groups in Guizhou. The pulmonary TB patient's medical expenditures were mainly direct ones before diagnosis and indirect ones after diagnosis.; Annual family income, comorbidity of chronic diseases, patient classification and hospitalization were the influencing factors for the incidence of CTC in the families of patients with pulmonary tuberculosis. It is necessary to conduct targeted health education and health promotion, strengthen the training and further education to improve doctors’ diagnosis and treatment levels, further optimize the medical insurance system, provide patients with compensation, and strengthen the active screening of pulmonary TB to jointly reduce the economic burden of pulmonary TB patients and incidence of CTC.