scholarly journals Evaluation of the Effect of the Capitation Compensation Mechanism among Tuberculosis Patients with a Full Period of Treatment

2021 ◽  
Author(s):  
xingyu hu ◽  
guangying gao
Keyword(s):  
Pulmonary Tuberculosis ◽  
Performance Management ◽  
Financial Burden ◽  
Medical Insurance ◽  
Insurance Fund ◽  
Compensation Mechanism ◽  
Payment Method ◽  
Tuberculosis Patients ◽  
Payment Methods ◽  
Full Period

Abstract Background: To explore the compensation mechanism for pulmonary tuberculosis patients with a full period of treatment, to alleviate the financial burden of pulmonary tuberculosis patients and to provide a reference and basis for the reform of tuberculosis payment methods in other regions and countries.Methods The funding operations of medical insurance institutions and the actual operating expenses of pilot hospitals from the Dehui Tuberculosis Hospital in Jilin Province were collected from the first half of 2015 to the first half of 2018, and the operational effects were analysed through quantitative and qualitative methods.Results After implementing the compensation mechanism, the medical expenses of tuberculosis patients decreased significantly, and the economic burden of the disease was reduced; the hospital's medical service capacity was improved, and internal management was significantly improved; and the medical insurance fund did not experience overspending, thus leading to a "triple win-win" situation.Conclusion The capitation compensation mechanism with a full period of treatment is a suitable payment method for TB diagnosis and treatment, and its effect is obvious, achieving a "triple win-win" for medical insurance, hospitals and patients. It is recommended to continue to promote this model to effectively reduce the financial burden of tuberculosis patients. However, in the early stage of the implementation of the plan, due to the relatively low understanding of the reform of hospitals and patients, there will be patient loss and poor compliance. Therefore, the hospital should change the management concept, incorporate the goal of payment method reform into performance management, and require all patients to be included in the treatment path to achieve standardized management of the entire treatment process. This mechanism also provides a reference for the reform of payment methods for tuberculosis in other regions or countries.

scholarly journals Evaluation of the effect of the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xing-Yu Hu ◽  
Guang-Ying Gao
Keyword(s):  
Pulmonary Tuberculosis ◽  
Patient Compliance ◽  
Quantitative Data ◽  
Financial Burden ◽  
Descriptive Analysis ◽  
Compensation Mechanism ◽  
Medication Costs ◽  
Implementation Time ◽  
Full Period ◽  
The Impact

Abstract Background PTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. Methods The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes. Results After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%. Conclusions The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.

Reforming Payment Methods for Basic Medical Insurance to Accommodate Traditional Chinese Medicine (TCM) in China : A Case Study of Shaanxi Province

2020 ◽  
Author(s):  
FANG ZHOU ◽  
XIAOHAO ZHANG ◽  
ZHIGUO MA
Keyword(s):  
Medical Insurance ◽  
Diagnosis And Treatment ◽  
Shaanxi Province ◽  
Insurance Fund ◽  
Payment Methods ◽  
Treatment Services ◽  
Basic Medical Insurance ◽  
Medical Institutions ◽  
Insurance Funds ◽  
Basic Medical

Abstract Background: Traditional Chinese medicine (TCM) attaches importance to the philosophy of holism and disease prevention. Meanwhile, costs arising from TCM diagnosis and treatment services are relatively low. Such features cater to the needs of less developed countries and regions to increase the equity and accessibility of medical services and to save basic medical insurance funds. However, China’s current payment system for basic medical insurance fails to fully regard these features, thus unable to incent the demand for and supply of TCM services. Methods: Based on the analysis of the features or rather the advantages of TCM, the article, taking Shaanxi Province located in central China as an example, studies the status quo of economic development, coverage of TCM diagnosis and treatment services by basic medical insurance, implementation of payment methods for basic medical insurance in TCM medical institutions, and aims to explore the reformation of payment methods for basic medical insurance. Results: Statistics have shown that the economic power of Shaanxi Province is below average in China, as a result of which, Shaanxi Province is confronted with a general lack of basic medical insurance fund. On the other hand, the present payment methods for basic medical insurance fail to accommodate the features of TCM. Besides, only a very limited number of TCM medical institutions, service items and medicines are covered by basic medical insurance. Consequently, the advantages of TCM are not exploited to the full in a country that has always treasured TCM. Therefore, reformation in payment methods is pressing. Conclusion: In view of the economic and social development of Shaanxi Province, this article proposes to reform the payment methods for basic medical insurance by introducing a new medicinal-effect-based payment method to accommodate TCM. This payment method has the following four features. Firstly, it advocates strengthening process supervision of diagnosis and treatment activities in medical institutions, establishing a rating system for therapeutic or prophylactic effects, and implementing a reward and punishment mechanism accordingly. Secondly, special audit standards for TCM services shall be determined by the health care department of the people’s government together with the relevant TCM administrative department, more TCM institutions, service items and medicines shall be covered by basic medical insurance, and the negotiation mechanism with medical insurance institutions shall be adjusted. Thirdly, in pricing the fees and standards for TCM services, the price control administrations of the people’s government shall consult TCM experts, and dynamic price adjustments based on costs and professional technical values shall be made. Last but not least, outpatient diagnosis and treatment services shall be covered by basic medical insurance fund, a practice which will not only give full play to the advantages TCM services, but also help reduce the financial burden on patients and save medical insurance funds.

scholarly journals Assessment of Depression among Pulmonary Tuberculosis Patients: A Cross-Sectional Study from Pakistan.

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Madeeha Malik ◽  
Rida Nasir ◽  
Azhar Hussain
Keyword(s):  
Pulmonary Tuberculosis ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Study Patient ◽  
Sectional Study ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Baseline Phase ◽  
Tuberculosis Patients ◽  
Significant Difference

<strong>Background:</strong> Depression is a condition that is often co-morbid to tuberculosis and can lead to increased morbidity and mortality associated with tuberculosis. The current prevalence of depression worldwide among individuals receiving treatment for TB ranged from 11.3% to 80.2%, with a mean weighted prevalence of 48.9%. The aim of the current study was to assess depression among tuberculosis patients in Pakistan. <strong>Methods </strong>A descriptive cross-sectional study design was used to evaluate depression among pulmonary tuberculosis patients in Pakistan. All the public and private tertiary healthcare facilities treating TB located in Rawalpindi and Islamabad were included in the study. Patient health questionnaire-9 (PHQ-9) was used to collect data from 382 patients of pulmonary tuberculosis. Non-parametric tests, Mann-Whitney and Kruskal-Wallis, were performed to find out the difference among different variables. <strong>Results &amp; Conclusion: </strong>Kruskal-Wallis and Mann-Whitney (p ≥ 0.05) were performed to find out the differences among different variables. Significant difference between different income levels (p=0.002), duration of treatment (p=0.01), phase of treatment (p=0.03) and type of treatment (p=0.001) were observed. Moderate depression was observed among patients at baseline and had duration of treatment less than a month. The present study concluded that majority of patients suffering from tuberculosis suffered from some sort of depression. This depression was more evident at baseline phase of therapy. Patients undergoing directly observed therapy appeared to be more depressed due to increased stigma along with increase in financial burden. Counseling and psychotherapy can play a massive role in combating depression and improving medication adherence in TB patients.

Detection of Mycobacterium tuberculosis in smear negative sputum by PCR

2012 ◽  
Vol 6 (2) ◽  
pp. 2-6 ◽  
Author(s):  
Mohammad Jobayer ◽  
SM Shamsuzzaman ◽  
Kazi Zulfiquer Mamun
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Accurate Method ◽  
Major Health Problem ◽  
Major Health ◽  
Tuberculosis Patients ◽  
Diagnostic Potential ◽  
Total Death ◽  
Smear Negative ◽  
Negative Sputum

Pulmonary tuberculosis is a major health problem in Bangladesh that is responsible for about 7% of total death in a year. This study was conducted to isolate and identify Mycobacterium tuberculosis from sputum and to evaluate the efficacy of PCR as a modern diagnostic tool, for diagnosis of pulmonary tuberculosis, especially in the smear negative cases. One hundred and fifty suspected pulmonary TB patients (male/ female: 97/53) were included in this study. Single morning sputum was collected from each patient and diagnostic potential of PCR was compared with staining and culture. Twenty five (16.7%) sputum were positive by ZN stained smear. Among 125 smear negative samples, 13 (10.4%) yielded growth in culture in LJ media and 21 (16.8%) samples were positive by PCR. The sensitivity and specificity of PCR in smear negative cases was 100% and 92.9% respectively. Mean detection time in PCR was 24 hours. PCR detected M. tuberculosis in 21 smear negative and 9 culture negative samples. For diagnosis of tuberculosis in smear negative cases, PCR directly from sputum was a very sensitive and accurate method. In conclusion, PCR may be done, especially in clinically suspected pulmonary tuberculosis patients who remain negative by conventional methods.DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19368 Bangladesh J Med Microbiol 2012; 06(02): 2-6

Kualitas Hidup Pasien Tuberkulosis Paru yang Mengalami Stigma Diri (Quality of Life Pulmonary Tuberculosis Patients With Self Stigma))

2019 ◽  
Vol 3 (2) ◽  
pp. 17-27
Author(s):  
Yunita Sari
Keyword(s):  
Quality Of Life ◽  
Pulmonary Tuberculosis ◽  
Descriptive Study ◽  
Negative Influence ◽  
Questionnaire Data ◽  
Average Quality ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Life Score

Pulmonary tuberculosis (TB) is a chronic disease that can bring about the sufferer's self-stigma and also affect his quality of life. A number of studies report that living with TB has a negative influence on the quality of life of sufferers even with or without self-stigma. The purpose of this study was to identify the quality of life of TB patients who experienced self-stigma. This research is a descriptive study, sample were 31 pulmonary TB patients. Data was collected using a questionnaire. Data analyzed by using frequency distribution and percentage. The researcher first screened TB patients who experienced self-stigma. The results showed that 25 people (80.64%) respondents experienced mild self-stigma. A total of 9 respondents (36%) had a quality of life score in the good category and as many as 16 respondents (64%) had enough category with an average quality of life score is 56.57. While respondents who had moderate self-stigma were 6 people (19.36%) with a good quality of life score was 1 person (16.67%) and enough category quality of life score were 5 people (83.33%) with an average quality of life score is 49.92.

Determination some Immunological Aspects in Pulmonary Tuberculosis Patients in Qadisiyah Province

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Syoof Khowman Alramahy ◽  
Akram Hadi Hamza
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Statistical Difference ◽  
Positive Culture ◽  
Control Group ◽  
Tuberculosis Patients ◽  
Significant Difference ◽  
Lowenstein Jensen ◽  
The Mean ◽  
Igg Level

This study was carried out to study of some immunological aspects among the pulmonary Tuberculosis patients infected with causative agent, Mycobacterium tuberculosis. A Total of 200 sputum samples were collected from patients attending the consultant Clinic for Chest and Respiratory disease center, Diwaniya. Control group (No=15) also included. According to acid fast stain of sputum, the patients were classified as positive (No=91,45.5%) and negative (No=109,54.5, Lowenstein Jensen medium used for the cultivation of samples, on which 70% of sputum samples where positive culture for this microorganism. The grown microorganism were identified as M. tuberculosis, based on positive A.F.B, Niacin producers ,negative for catlase at 68c. The mean IgG level was l184.053±76.684 mg/100 ml in tuberculosis group compared with 1016.533 ± 44.882 mg/100ml in control group, rendering the statistical difference significant. For IgA and IgM levels, they were at mean of 315.880±38.552 mg/100 ml and 119.527±8.464 mg/100 ml in control group compared with 396.358±38.776 mg/100 ml and 134.207±11.696 mg/100 ml in patients group respectively with significant difference

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