Abstract: Objective To understand the medical seeking behavior and medical expenses of rifampicin-resistant pulmonary tuberculosis patients with different types of medical insurance before and after diagnosis, so as to provide reference for policy-making. Method A quantitative questionnaire survey was conducted among rifampicin resistant pulmonary tuberculosis patients registered in the tuberculosis information management system in Foshan from 2018 to 2019 with the treatment outcome of "cured" and "completed " to understand the medical seeking behavior and medical expenses before and after diagnosis. Result A total of 56 patients were included in the survey. 39 patients (69.6%), 14 patients(25.0%) and 3 patients (5.4%) were found through symptomatic visits, annual physical examination, and close contact screening respectively. Among 11 employee medical insurance patients, 4 cases (36.4%) were found through the annual physical examination, which was higher than that of other medical insurance patients. 49 patients (87.5%) had been hospitalized, with an average hospital stay of 27 days. 47 patients (83.9%) adopted self-managed medication during outpatient treatment. The average cost of the included patients from first visit to completion of treatment was 29 804 yuan, and the average reimbursement was 7816 yuan (26.2%). Employee medical insurance patients have the highest reimbursement ratio before diagnosis and inpatient and outpatient after diagnosis. Conclusion There are differences in medical seeking behavior, treatment management and direct medical expenses among pulmonary tuberculosis patients with different types of medical insurance. We should further strengthen efforts to detect drug-resistant patients as soon as possible, take measures to enhance patient's medication management, and improve the health security level and reduce patient’s economic burden.

Key words: Tuberculosis, Rifampicin-resistant, Medical seeking, Expense, Investigation