Identifying costs contributing to catastrophic expenditure among TB patients registered under RNTCP in Delhi metro city in India.
Adolescent
Adult
Aftercare
/ economics
Aged
Antitubercular Agents
/ therapeutic use
Child
Child, Preschool
Cost of Illness
Delivery of Health Care
Employment
/ economics
Female
Financial Support
Food
/ economics
Health Expenditures
Hospitalization
/ economics
Humans
Income
India
Male
Medication Adherence
Middle Aged
Sick Leave
Travel
/ economics
Tuberculosis
/ diagnosis
Young Adult
Catastrophic expenditure
Direct-indirect costs
Economic impact
Out-of-pocket expenditure
Tuberculosis
Journal
The Indian journal of tuberculosis
ISSN: 0019-5707
Titre abrégé: Indian J Tuberc
Pays: India
ID NLM: 0373027
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
09
08
2018
accepted:
29
10
2018
entrez:
25
2
2019
pubmed:
25
2
2019
medline:
19
12
2019
Statut:
ppublish
Résumé
Tuberculosis (TB) patients often incur large costs related to illness, as well as for seeking and receiving health care. Despite TB treatment being free under RNCTP, out of pocket expenditure incurred (OOP) by patients for TB diagnosis and treatment impoverishes the households. This expenditure may turn catastrophic (more than 20% of their family income) impacting adherence and leading to poor treatment outcomes. To estimate the proportion of households experiencing catastrophic expenditure due to TB and also to find out the various costs contributing to catastrophic expenditure. In this cohort study, 450 TB patients (including 96 children) registered under Revised National Tuberculosis Control Programme (RNTCP) in Delhi were interviewed at three different time points (in the beginning of treatment, end of intensive phase, end of treatment). Interview schedule was used to collect information on direct medical and non-medical, and indirect costs. The TB-specific indicator of "catastrophic total costs" incorporates both, direct medical and non-medical payments for treatment such as transportation, lodging charges and indirect costs such as wage loss. A total of 450 patients were enrolled in this study, out of which 425 were followed up to the end of treatment. It was observed that 7% of TB patients registered under RNTCP in Delhi experienced catastrophic expenditure due to TB. The total mean cost to patients with TB was Rs. 12165 (Rs. 1406 during diagnosis and Rs. 10759 during treatment). The indirect cost was higher compared to direct cost i.e.Rs. 7564 and Rs. 4601 respectively). This information will be useful for policy makers to design an intervention to provide financial protection to TB patients. In addition, findings of this study will aid in providing baseline evidence to periodically measure the OOP which is the one of the End TB strategy target.
Sections du résumé
BACKGROUND
BACKGROUND
Tuberculosis (TB) patients often incur large costs related to illness, as well as for seeking and receiving health care. Despite TB treatment being free under RNCTP, out of pocket expenditure incurred (OOP) by patients for TB diagnosis and treatment impoverishes the households. This expenditure may turn catastrophic (more than 20% of their family income) impacting adherence and leading to poor treatment outcomes.
OBJECTIVE
OBJECTIVE
To estimate the proportion of households experiencing catastrophic expenditure due to TB and also to find out the various costs contributing to catastrophic expenditure.
METHODS
METHODS
In this cohort study, 450 TB patients (including 96 children) registered under Revised National Tuberculosis Control Programme (RNTCP) in Delhi were interviewed at three different time points (in the beginning of treatment, end of intensive phase, end of treatment). Interview schedule was used to collect information on direct medical and non-medical, and indirect costs. The TB-specific indicator of "catastrophic total costs" incorporates both, direct medical and non-medical payments for treatment such as transportation, lodging charges and indirect costs such as wage loss.
RESULTS
RESULTS
A total of 450 patients were enrolled in this study, out of which 425 were followed up to the end of treatment. It was observed that 7% of TB patients registered under RNTCP in Delhi experienced catastrophic expenditure due to TB. The total mean cost to patients with TB was Rs. 12165 (Rs. 1406 during diagnosis and Rs. 10759 during treatment). The indirect cost was higher compared to direct cost i.e.Rs. 7564 and Rs. 4601 respectively).
CONCLUSION
CONCLUSIONS
This information will be useful for policy makers to design an intervention to provide financial protection to TB patients. In addition, findings of this study will aid in providing baseline evidence to periodically measure the OOP which is the one of the End TB strategy target.
Identifiants
pubmed: 30797274
pii: S0019-5707(18)30281-6
doi: 10.1016/j.ijtb.2018.10.009
pii:
doi:
Substances chimiques
Antitubercular Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-157Informations de copyright
Copyright © 2018 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.