Cost of Care in Tb Patients, Its Social Implications and Impact on Management of Patients

Abstract

Introduction: Tuberculosis is an increasing problem for the developed world, particularly among the economically deprived. TB patients have to suffer poverty because of cost of treatment as well as DALY lost. TB is not only a medical disease but it has a wider ramication on the socioeconomic as well as the psychological aspect of patient, The increasing cost of care in acts as a barrier for achieving optimum management and sometimes disproportionately affects the outcome. To study the expenses incurred Aim: by TB patients both direct and indirect, to account for the social implications of TB in the society and how it affects the management of such patients . This Hospital based study Material and Methods: including IPD and OPD patients in Respiratory Medicine of Maharishi Markandeshwar Institute of Medical Science And Research, Mullana (Ambala) (Deemed to be University), using a semi structured questionnaire was used to interview the patients regarding the various expenses they had during the treatment, how it affected their social life and any complications they faced. The results were analysed with similar studies conducted previously in different countries. Results: Pre-diagnostic/diagnostic costs were Rs 2738.20 and Rs 5072 respectively. Total cost during treatment and total guardian costs were Rs 1604 and Rs 5928.57 respectively. Total mean annual income of the patients was Rs 209320 while total mean cost for TB treatment was Rs 29316.60. Of the total 100 patients, 74 went to government centres and 26 went to private for treatment, the most common reason for choosing private facilities was that it was time consuming followed by Distance to facility. 20% people sold some sort of property to nance treatment.24% people faced catastrophic costs of Tb and 77% patients who incurred catastrophic costs had some form of post treatment complications Conclusion: There are many indirects costs in TB treatment that are not accounted for, the expenses lead to catastrophic costs for the patient as well as the household. The social implication of Tb including loss of job and separation from friends spouse and family, Catastrophic patients are associated with adverse outcome and the patients had to pay over and above the treatment cost due to complications arising from tuberculosis and led to stopping of treatment in between.