Differences Between the Local and Migrant Populations in Healthcare Service Use and Direct Cost of Tuberculosis Treatment - Shanghai Municipality, China, 2020-2021.

What is already known about this topic?: Tuberculosis (TB) disproportionately affects socially vulnerable populations, particularly the migrant population. Shanghai has implemented a policy providing additional reimbursement for TB diagnosis and treatment beyond standard health insurance coverage for residents. However, comprehensive evidence on TB care utilization patterns and treatment costs remains limited, especially on the disparities between local and migrant populations. What is added by this report?: From 2020 to 2021, local and migrant TB patients in Shanghai demonstrated comparable outpatient visit frequencies with an overall hospitalization rate of 85.7%. Migrant TB patients without resident permits are ineligible for government reimbursement, resulting in over half of the patients encountering out-of-pocket costs that exceed 20% of their annual household income for TB treatments. What are the implications for public health practice?: The government's reimbursement policy should be expanded to include the most vulnerable populations, specifically migrant patients without residency permits, to strengthen the financial risk protection for TB patients.