providing financial incentives to rural-to-urban tuberculosis migrants in shanghai an intervention study提供财政激励措施,北京市结核病移民在上海一个干预研究.pdfVIP

Wei et al. Infectious Diseases of Poverty 2012, 1:9 /content/1/1/9 RESEARCH ARTICLE Open Access Providing financial incentives to rural-to-urban tuberculosis migrants in Shanghai: an intervention study 1 2* 2 3 4 3 5 Xiaolin Wei , Guanyang Zou , Jia Yin , John Walley , Huaixia Yang , Merav Kliner and Jian Mei Abstract Background: Financial issues are major barriers for rural-to-urban migrants accessing tuberculosis (TB) care in China. This paper discusses the effectiveness of providing financial incentives to migrant TB patients (with a focus on poor migrants in one district of Shanghai using treatment completion and default rates), the effect of financial incentives in terms of reducing the TB patient cost, and the incremental cost-effectiveness ratio of the intervention. Results: Ninety and ninety-three migrant TB patients were registered in the intervention and control districts respectively. TB treatment completion rates significantly improved by 11% (from 78% to 89%) in the intervention district, compared with only a 3% increase (from 73% to 76%) in the control district (P = 0.03). Default rates significantly decreased by 11% (from 22% to 11%) in the intervention district, compared with 1% (from 24% to 23%) in the control district (P = 0.03). In the intervention district, the financial subsidy (RMB 1,080/US$170) accounted for 13% of the average patient direct cost (RMB 8,416/US$1,332). Each percent increase in treatment completion costs required an additional RMB 6,550 (US$1,301) and each percent reduction in defaults costs required an additional RMB 5,240 (US$825) in the intervention district. Conclusions: Overall, financial incentives proved to be effective in improving treatment