SHANDONG UNIVERSITY- CHINA

Evaluating the impact of the New Cooperative Medical Scheme (NCMS) on TB control - in rural China

This study is being carried out by COMDIS, Shandong University and the Chinese University of Hong Kong. It aims to gain a better understanding of the impact of the New Cooperative Medical Scheme (NCMS) on Tuberculosis (TB) patients and health providers. It also hopes to determine how the NCMS, a voluntary health insurance system for China's rural population, can be improved.

The NCMS is used by 92% of China's rural population. It is expected to relieve the financial burden of low-income patients. The scheme covers hospitalisation by co-payment. The cost of outpatient care, however, is usually left uncovered or only partly lightly covered. Our previous research has shown how, though TB microscopy is free, often other tests and treatments are prescribed at high cost to the patient. Of particular concern is that, to maximise revenue, patients with straight forward TB are often hospitalised unnecessarily.

Two provinces, Zhejiang and Sichuan have been selected for this study. Four countries, two with health schemes covering TB outpatient services and two that do not offer these services, are being studied in each province.

The researchers will conduct interviews with health staff including the director of the health bureau responsible for NCMS and a clinical doctor from the TB dispensaries. Topics include TB related reimbursement, NCMS fund utilisation and management.

The researchers will also analyse information from patient chart reviews, patient questionnaires and opinions of insurance and service providers.