Cost of Tuberculosis Treatment: Evidence from Iran's Health System

Bay, Vahid; Tabarsi, Payam; Rezapour, Aziz; Marzban, Sima; Zarei, Ehsan

doi:10.24171/j.phrp.2017.8.5.09

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…29 The total cost of treating a new smear-positive pulmonary TB patient in Iran was USD 1,409 which was split into direct and indirect costs (USD 1,226.00 and USD 183.00) respectively but these figures were three times more than our median costs. 30…”

Section: Discussionmentioning

confidence: 99%

Expenditure Incurred by Patients of Pulmonary and Extrapulmonary Tuberculosis Under Revised National Tuberculosis Control Programme in District Tuberculosis Center, Jammu

Kalotra

Kumar²,

Kumar

et al. 2023

Natl J Community Med

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Background: Tuberculosis (TB) patients suffer enormously due to huge cost on diagnosis and treatment. This study aims to assess the total expenditure and its predictors among patients of TB. Methodology: A longitudinal study was conducted among TB Patients registered in first quarter of 2018 at District Tuberculosis Center, Jammu. Data was collected by interviewing the patients and their attendants. Statistical significance of median expenditure between patients of pulmonary and extrapulmonary TB in relation to various predictors was assessed using nonparametric tests followed by Multiple Linear Regression. Results: Total median cost, median direct and indirect cost incurred by a TB patient were recorded as USD 489.55, USD 246.55 and USD 229.5 respectively. Treatment costs were slightly higher in patients of pulmonary TB in comparison to extrapulmonary TB (p>0.05). On bivariate analysis, upper class, previously treated patients, Category 2 patients, with chronic illnesses, with guardians and who were employed expended significantly higher amounts on their treatment, but on multivariate analysis, only formal employment, current earning and being reimbursed significantly predicted the total cost (p < .001, adjusted R square = 0.56). Conclusion: Huge direct costs incurred by patients is a matter of great concern, more so as the Indian government has made all diagnostics and treatment free since the inception of the RNTCP.

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Section: Discussionmentioning

confidence: 99%

Expenditure Incurred by Patients of Pulmonary and Extrapulmonary Tuberculosis Under Revised National Tuberculosis Control Programme in District Tuberculosis Center, Jammu

Kalotra

Kumar²,

Kumar

et al. 2023

Natl J Community Med

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show abstract

“…Patients with sputum smear-negative TB (SSNTB) are less infectious than patients with sputum smear-positive TB (SSPTB) [ 7 ]. A new detected SSPTB patient costs US$ 1409 for the Iranian health system [ 8 ]. A systematic review and meta-analysis in 2019 showed that health care workers residing in the northern and the western regions of the country had the highest prevalence of latent TB, i.e.…”

Section: Introductionmentioning

confidence: 99%

Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018

et al. 2021

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Background Effective reduction of tuberculosis (TB) requires information on the distribution of TB incidence rate across time and location. This study aims to identify the spatio-temporal pattern of TB incidence rate in Iran between 2008 and 2018. Methods This cross-sectional study was conducted on aggregated TB data (50,500 patients) at the provincial level provided by the Ministry of Health in Iran between 2008 and 2018. The Anselin Local Moran’s I and Getis-Ord Gi* were performed to identify the spatial variations of the disease. Furthermore, spatial scan statistic was employed for purely temporal and spatio-temporal analyses. In all instances, the null hypothesis of no clusters was rejected at p ≤ 0.05. Results The overall incidence rate of TB decreased from 13.46 per 100,000 (95% CI: 13.19–13.73) in 2008 to 10.88 per 100,000 (95% CI: 10.65–11.11) in 2018. The highest incidence rate of TB was observed in southeast and northeast of Iran for the whole study period. Additionally, spatial cluster analysis discovered Khuzestan Province, in the West of the country, having significantly higher rates than neighbouring provinces in terms of both total TB and smear-positive pulmonary TB (SPPTB). Purely temporal analysis showed that high-rate and low-rate clusters were predominantly distributed in the time periods 2010–2014 and 2017–2018. Spatio-temporal results showed that the statistically significant clusters were mainly distributed from centre to the east during the study period. Some high-trend TB and SPPTB statistically significant clusters were found. Conclusion The results provided an overview of the latest TB spatio-temporal status In Iran and identified decreasing trends of TB in the 2008–2018 period. Despite the decreasing incidence rate, there is still need for screening, and targeting of preventive interventions, especially in high-risk areas. Knowledge of the spatio-temporal pattern of TB can be useful for policy development as the information regarding the high-risk areas would contribute to the selection of areas needed to be targeted for the expansion of health facilities.

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“…The incidence rate of tuberculosis is about 365 cases per 100,000 people in Africa; it is about 5 people per 100,000 people in London; it is about 21 people per 100,000 people in Spain; it is 5 people per 100,000 people in America; and globally, on average, it is 13 cases per 100,000 people. In Iran, the incidence rate of tuberculosis reached 16 cases per 100,000 people in 2015 and declined to 14 cases per 100,000 people in 2016 and 2017, and fell to 13 cases per 100,000 people in 2020, where 4% of cases of tuberculosis patients were under 14 years old [ 5 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Distribution incidence, mortality of tuberculosis and human development index in Iran: estimates from the global burden of disease study 2019

Fallahzadeh,

Khazaei,

Najafi

et al. 2023

BMC Public Health

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Background Tuberculosis is one of the most serious challenges facing the global healthcare system. This study aims to investigate the incidence and mortality of tuberculosis in Iran from 2010 to 2019 as well as its relationship with the human development index (HDI). Methods The present study is an ecological study aiming at investigating the incidence and mortality of tuberculosis in Iran during the years 2010 to 2019. The related data were extracted from the Global Burden of Disease (GBD) website. The spatial pattern attributed to tuberculosis in the provinces of Iran was analyzed using ArcGIS software. In this study, the two-variable correlation method was used to analyze the data extracted to study the correlation between Tuberculosis and HDI. Result Based on the results recorded in GBD, the incidence of tuberculosis in 2010, that is, 14.61 (12.72, 16.74), declined compared to 2019, namely 12.29 (10.71, 14.09). The age-standardized mortality rate which was 1.63 (1.52, 1.73) in 2010, has decreased compared to 2019: 1.17 (1.07, 1.32). The incidence and mortality rates of tuberculosis in Iran in all age groups have decreased in 2019 compared to 2010. The highest incidence and mortality among tuberculosis patients were recorded in Sistan and Baluchistan and Golestan provinces. The results indicated that there was a negative and significant correlation between the mortality rate of tuberculosis and the human development index in 2010 (r = -0.509, P-value = 0.003) and 2019 (r = -0.36, P-value = 0.001); however, this correlation between incidence and human development index was not significant (p > 0.05). Conclusion Since mortality is mostly observed in areas with low HDI, health system policymakers must pay more attention to these areas in order to improve care and perform screenings to diagnose and treat patients thus reducing the mortality rate of tuberculosis and preventing an increase in its incidence in Iran.

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Cost of Tuberculosis Treatment: Evidence from Iran's Health System

Cited by 9 publications

References 18 publications

Expenditure Incurred by Patients of Pulmonary and Extrapulmonary Tuberculosis Under Revised National Tuberculosis Control Programme in District Tuberculosis Center, Jammu

Expenditure Incurred by Patients of Pulmonary and Extrapulmonary Tuberculosis Under Revised National Tuberculosis Control Programme in District Tuberculosis Center, Jammu

Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018

Distribution incidence, mortality of tuberculosis and human development index in Iran: estimates from the global burden of disease study 2019

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