OBJECTIVES : To analyze on the direct medical expenses and its influencing factors of patients with pulmonary tuberculosis (TB) from 2011 to 2018 in Wuhan, and to provide references for improving the medical assistance policy in China.

METHODS : We studied on a total of 17,522 TB patients with 1,258,953 medical records in Wuhan province, and analyzed the different kinds of direct medical expenses and its influencing factors by descriptive statistics and quantitative methods such as ranksum test, multivariable linear regression and generalized estimated equation.

RESULTS : From 2011 to 2018, the average total direct medical expenses was 45731.45 yuan per TB patient in Wuhan province, 147.51 yuan per outpatient visit, and 8849.57 yuan per inpatient visit. And each patient cost 9607.01 yuan per year. The average reimbursement rate was 6.36% for outpatients and 67.56% for inpatients. The main population of TB patients were aged between 30-60 (49%), and most of the patients (73.71%) were covered by the Urban Employee Basic Medical Insurance (UEBMI), which had a higher reimbursement ratio compared to other medical insurance types. Factor analysis showed that the direct medical expenses were related to patients’ age, sex, year of visit, health care insurance type, medical institution levels and whether they had surgery and Chinese traditional medicine or not (P<0.01).

CONCLUSIONS : The current direct medical expenses of TB patients are relatively affordable, but for low-income patients and patients in severe condition, the financial burden is still heavy. Improved medical assistance policies are in need.