Browsing by Person "Yin, J."

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Incremental cost-effectiveness of improving treatment results among migrant tuberculosis patients in Shanghai
(2013-08) Zou, G.; Wei, X.; Witter, Sophie; Yin, J.; Walley, J.; Liu, S.; Yang, H.; Chen, J.; Tian, G.; Mei, J.
SETTING: Two projects were introduced in October 2007 to improve treatment completion among rural-to-urban migrant tuberculosis (TB) patients in Shanghai. The Communicable Disease Research Consortium (COMDIS) project provided financial incentives to poor patients, whereas the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) project provided incentives to all patients and increased staff time. OBJECTIVE: To assess the incremental cost-effectiveness of these two projects. METHODS: Case study. Costs were assessed from a societal perspective. The primary measure of effectiveness was the treatment completion rate. The incremental cost- effectiveness ratio was calculated as the additional cost of the intervention divided by the additional percentage of patients completing treatment compared to controls. RESULTS: Post intervention, the treatment completion rates in the COMDIS and Global Fund projects were respectively 89% and 88%, 17% and 16% higher than in the control district (76%). For one additional percent of patients to complete treatment, the additional cost of the COMDIS intervention was US$1891, 91% lower than that of the Global Fund intervention (US$21 904). CONCLUSION: The intervention that addressed the financial barriers of poor patients was more cost-effective than the comprehensive intervention that provided assistance to both patients and providers. Further study is needed to understand the process of interventions prior to wider scale-up. 2013 The Union.
Patient care pathways under the model of integrating tuberculosis service with general hospitals in China
(Blackwell Publishing Ltd, 2013-10) Wei, X.; Yin, J.; Zou, Guanyang
Objective: To report care pathways of tuberculosis (TB) patients under the integrated model, where TB clinical service is provided by a general hospital instead of the TB dispensary, with the aim of providing policy recommendations for TB care reforms in China. Methods: Six counties implementing the integrated model were randomly selected, and 50 TB patients in each county participated in a questionnaire survey. Results: Of the 301 participants, 82 visited only the TB designated hospital. A patient visited a median of two health providers in total. The median external provider delay and internal provider delay were 1 and 0 day, respectively. The median out-of-pocket medical costs were US$379 in total; US$293 in the TB units and US$0 in other health units in the TB designated hospital. Logistic regression analyses suggested that patients who visited the primary care facilities first tended to have longer external delays (OR = 5.71) than patients who visited the other hospitals (OR = 10.16). Conclusion: The integrated model is promising as it reported relatively fewer patient pathways and shorter delays than the dispensary model. However, the integrated model did not reduce patient out-of-pocket costs. 2013 John Wiley & Sons Ltd.