Innovative social protection mechanism for alleviating catastrophic expenses on multidrug-resistant tuberculosis patients in Chhattisgarh, India.
Innovative social protection mechanism for alleviating catastrophic expenses on multidrug-resistant tuberculosis patients in Chhattisgarh, India.
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DOI：
10.4103/2224-3151.206624
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发表时间：
2015-01-01
影响因子：
--
通讯作者：
Parmar, Malik
中科院分区：
文献类型：
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作者：
Kundu, Debashish;Katre, Vijendra;Parmar, Malik
背景技术背景：耐多药结核病患者的诊断和治疗费用巨大;这些费用可以通过设计和实施良好的社会健康保险机制来降低。印度的恰蒂斯加尔邦成功地在经修订的国家结核病控制方案和健康保险方案之间建立了伙伴关系，通过制定Rashtriya Swasthya比马Yojna（RSBY）和Mukhyamantri Swasthya比马Yojana（MSBY）耐多药结核病一揽子计划，形成了一个全民健康保险计划。这一伙伴关系的目标是在公共和私营部门承担耐多药结核病患者从诊断到完成治疗的灾难性费用。本文记录了一个量身定制的医疗保险计划的初步经验，与MDR-TB.METHODS患者的灾难性医疗支出相联系：在这项描述性研究中，通过创新的MDR-TB包从2013年1月至2014年4月的保险索赔的数据收集。在恰蒂斯加尔的两个主要城区进行了一项简单的临床调查和住院治疗费用调查。在这些选定的地区，RSBY和MSBY国家节点机构选择了三个私营部门的卫生设施和一个公共部门的医学院，并设有一个功能性耐药结核病中心，以完成一份关于现有市场价格的简单结构化问卷。临床调查和住院时间的平均成本计算为一个人的病人与耐多药结核病谁会寻求服务，从私营或公共sect.RESULTS：共207保险索赔RSBY和MSBY耐多药结核病包处理，其中20个是从私人和187从公共卫生机构，根据医疗保险计划，免费。估计灾难性的支出，约为20 000美元，节省了通过RSBY和MSBY健康保险机制在研究period.CONCLUSION：创新的RSBY和MSBY耐多药结核病保险包是一个步骤，减少与耐多药结核病治疗的灾难性费用。
BACKGROUND: Patients with multidrug-resistant tuberculosis (MDR-TB) incur huge expenditures for diagnosis and treatment; these costs can be reduced through a well-designed and implemented social health insurance mechanism. The State of Chhattisgarh in India successfully established a partnership between the Revised National TB Control Programme (RNTCP) and the Health Insurance Programme, to form a universal health insurance scheme for all, by establishing Rashtriya Swasthya Bima Yojna (RSBY) and Mukhyamantri Swasthya Bima Yojana (MSBY) MDR-TB packages. The objective of this partnership was to absorb the catastrophic expenses incurred by patients with MDR-TB, from diagnosis to treatment completion, in the public and private sector. This paper documents the initial experience of a tailor-made health insurance programme, linked to covering catastrophic health expenditure for patients with MDR-TB.METHODS: In this descriptive study, data on uptake of insurance claims through innovative MDR-TB packages from January 2013 to April 2014 were collected. A simple survey of costs for clinical investigation and inpatient care was conducted across two major urban districts in Chhattisgarh. In these selected districts, three health facilities from the private sector and one medical college from the public sector with a functional drug-resistant tuberculosis (DR-TB) centre were chosen by the RSBY and MSBY State Nodal Agency to complete a simple, structured questionnaire on existing market rates. The mean costs for clinical investigations and hospital stay were calculated for an individual patient with MDR-TB who would seek services from the private or public sector.RESULTS: A total of 207 insurance claims for RSBY and MSBY MDR-TB packages were processed, of which 20 were from private and 187 from public health establishments, covered under the health insurance programme, free of charge. An estimated catastrophic expenditure, of approximately US$ 20 000, was saved through the RSBY and MSBY health insurance mechanism during the study period.CONCLUSION: The innovative RSBY and MSBY MDR-TB insurance package is a step towards reducing catastrophic expenses associated with treatment for MDR-TB.