Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

Abstract

Background Illness-related costs experienced by tuberculosis patients produce a severe economic impact on households, especially poor families. Few studies have investigated the full costs, including direct and indirect costs, at the patient and household levels in southeast China. Methods A case follow-up study was conducted in the Bao'an district of Shenzhen City, China. Eligible new and previously treated individuals with pulmonary tuberculosis (TB) during January 1 st 2013 to June 30 th 2013 were enrolled. Medical and non-medical costs as well as income loss were calculated in diagnosis and treatment periods, respectively. Factors associated with costs due to TB diagnosis, treatment and TB care (diagnosis + treatment) were explored respectively with a linear regression model. Results Of the total 514 TB patients enrolled, 95% were from the migrant population, and 65% were males, with a mean age of 32.25 (±10.11). The median costs due to TB diagnosis and TB treatment were 79 United States dollar (USD), 748USD (6.2897 China Yuan (CNY) = 1USD, 2013) per patient, respectively. The median costs due to TB care (diagnosis and treatment) per patient was 1218USD, corresponding to 26% of patients' annual income preillness. Those who visited more times to health facilities, hospitalized, received higher education, or occupied in national civil servant/services/retired staff might expense more before diagnosis. Costs due to TB treatment was significantly higher among migrant patients, sputum smear positive patients, and widowed/divorced population. Factors associated with less total costs were native patients, fewer times of visiting to health-care facilities and those with no hospitalization history due to TB.

Comparison of Delay in Tuberculosis Diagnosis Between Migrants and Local Residents in an Eastern County of China: An Analysis of the Electronic Data Between 2015 and 2019

“…The median (IQR) patient delay for the migrant patients with TB was 13 ( 4 – 34 ) days, significantly longer than the 9 ( 4 – 17 ) days for local patients with TB over 5 years ( P < 0.05). In addition, compared with the local patients with TB, the migrant patients with TB experienced significantly longer patient delays every year from 2015 to 2018 (P < 0.05).…”

“…In most places in China, patients with TB receive standardized diagnosis and treatment in the designated general hospital of the county, and other health facilities refer patients with TB or presumptive patients with TB to the designated TB hospitals for standardized diagnosis and treatment (14). Numerous studies have focused on the delay in TB diagnosis for migrants in China (13,(15)(16)(17)(18)(19)(20). However, most of these studies in China were conducted in big cities such as Shanghai and Shenzhen.…”

Willingness to seek medical care for tuberculosis and associated factors among the elderly population in Shenzhen: a cross-sectional study

“… 15 After patients start to take anti-TB drugs, they are required to visit the Centre for Chronic Disease Control every month for health checks until the treatment ends. 11 In addition to free TB drugs, the government provides subsidies for transportation and nutrition for low-income TB patients. 16 However, all patients must pay for monthly prescriptions for subsidiary drugs such as liver protection drugs, and auxiliary examinations, such as X-ray tests.…”

“… 16 However, all patients must pay for monthly prescriptions for subsidiary drugs such as liver protection drugs, and auxiliary examinations, such as X-ray tests. 11 17 …”

Cost-Effectiveness of Follow-Up of Chronic Coughers in Detecting Smear-Positive Tuberculosis in South Ethiopia

“…8 The disease imposes high economic burden on the poor households for seeking TB care. [9][10][11][12][13] In Ethiopia, sputum microscopy is the standard way of diagnosis of pulmonary TB and Directly Observed Treatment Short course (DOTS) is the standard approach for its treatment. 14 Despite the implementation of DOTS, low case findings persisted to be the challenge of TB care in southern Ethiopia.…”