目的 了解中国东部三市耐多药结核病（multi-drug resistant tuberculosis，MDR-TB）患者的经济负担情况，寻找减轻患者经济负担的方法。方法 采用自行设计的调查问卷对正在治疗的江苏省徐州市、宿迁市和江西省赣州市定点医院登记治疗的MDR-TB患者进行面对面调查，对已经结束治疗的患者进行电话调查，收集患者基本情况、经济负担等信息。采用χ²检验、线性回归等方法分析MDR-TB患者的经济负担情况。结果 三市共登记治疗MDR-TB患者233例，其中接受全球基金项目医疗费减免患者82人，最终151例患者纳入分析，平均年龄（43.36±16.18）岁，男性患者124例（82.1%）。MDR-TB患者直接经济负担平均为28 987元，中位数为23 740（14 100~37 580）元。多因素线性回归结果显示徐州患者直接经济负担显著高于宿迁（P=0.001）和赣州（P<0.001）。治疗前MDR-TB患者家庭年收入中位数为40 000（2 0000~60 000）元，患者个人收入中位数为15 000（0~36 000）元。所有患者中产生灾难性卫生支出的家庭比例为48.3%，徐州市患者产生灾难性卫生支出的家庭比例显著高于另两市（P=0.003）。结论 中国东部三市MDR-TB患者经济负担较重，因医保报销政策和用药方案的不同而差异较大。政府应该加强医疗保险的报销范围或报销力度，增加MDR-TB患者的费用补贴，减轻患者的经济负担。

Objective To understand the economic burden of multi-drug resistant tuberculosis (MDR-TB) patients in three cities in eastern China,and to find ways to reduce the financial burden on the patients. Methods The subjects of the study were MDR-TB patients registered and treated in designated hospitals in Xuzhou,Suqian of Jiangsu Province and Ganzhou of Jiangxi Province.Face-to-face investigation was conducted on the patients undergoing treatment,and telephone survey was conducted on the patients who have completed treatment by a self-designed questionnaire to collect demographic sociological information and economic burden of MDR-TB patients.χ² test and linear regression were used to analyze the economic burden of MDR-TB patients. Results A total of 233 patients with MDR-TB were registered in the 3 cities,of which 82 patients received reduction of medical expenses from global fund projects.Therefore,151 patients with an average age of (43.36±16.18) years were successfully investigated finally.There were 124 male patients (82.1%).The total direct financial burden of MDR-TB patients was 28 987 yuan on average, with a median of 23 740 (14 100-37 580) yuan.The results of multivariate linear regression showed that the direct economic burden of the patients in Xuzhou was significantly higher than that in Suqian (P=0.001) and Ganzhou (P<0.001).The annual median family income of MDR-TB patients before treatment was 40 000 (20 000-60 000) yuan,and the median family income before treatment was 20 000 (0-36 000) yuan. The percentage of families with catastrophic health expenditure was 48.3%.The proportion of patients with catastrophic health expenditure in Xuzhou was significantly higher than that in the other two cities (P=0.003). Conclusion The economic burden of MDR-TB patients in the 3 cities in eastern China was heavy and varied greatly with different medical insurance policies and therapeutic regimens.The government should strengthen the coverage or reimbursement of medical insurance,and increase the subsidy of MDR-TB patients to reduce the economic burden on patients.