交通费补助对贫困结核患者完成治疗支持作用的定性研究

目的:研究交通费补助项目对贫困结核病人完成治疗的支持作用及其影响因素。方法:在实施交通费补助项目的福建省、重庆市,完成结核病人、各级项目管理者个人深入访谈40个;对县/区结防所门诊医生和乡防保医生进行焦点组访谈4组。结果:交通费补助可以减轻贫困结核病人的交通费负担,在物质上和精神上支持受益病人完成治疗。但是由于缺乏鉴别贫困病人的有效工具,部分贫困结核病人未能受益。此外,有限的项目经费在一定程度上影响了项目的覆盖面和补助额度,继而影响了各地对项目的宣传和推介。结论:随访过程中的交通费仍然是贫困结核病人完成治疗的重要影响因素之一,为使所有贫困结核病人能够完成治疗,应合理界定贫困标准,根据就诊距离制定补助标准;在普遍贫困的中西部地区,可考虑对所有农村结核病人提供交通费补助。

A qualitative study of transport subsidy project on enabling poor TB patients to complete the treatment course

Objective： To evaluate the transportation subsidy project on enabling poor TB patients to complete the treatment course and to find out its influencing factors.Methods： In the project-covered Fujian province and Chongqing city,40 individual in-depth interviews were conducted among TB patients receiving or not receiving transport subsidies and project managers;and 4 focus group discussion were carried out with TB doctors and town-level anti-TB staff.Results： The transport subsidy was perceived by both TB patients and health providers as very useful for enabling poor patients to visit county TB Dispensary during treatment materially and mentally,but a lack of practical tool to identify poor patients resulted in that some poor TB patients were not benefited;In addition,the limited project funds,to some extent,constrained the subsidy amount and coverage of the project,and then confined the advertising and advancing of the project.Conclusion： Transport cost is still one of the major factors that influenced poor TB patients to complete treatment,In order to enable all poor TB patients to complete the treatment,it is necessary to develop a practical tool for identifying poor patients,and set-up a distant-based subsidy rank.For patients living in the relatively poor central and west areas of China,providing transport subsidy to all rural TB patients should be considered.