1921
Volume 103, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
USD
Buy:$15.00

Abstract

Abstract.

Costs related to tuberculosis (TB) can impose a significant burden on patients and their families and create barriers to diagnosis and treatment. Our study aimed to quantify out-of-pocket costs expended by TB patients in Bandung, Indonesia. This cross-sectional study recruited adults with TB from community health centers (CHCs), public and private hospitals, and private practitioners (PPs). An interview was completed at the time of diagnosis or at their return for 2- or 6-month treatment. Costs were converted to U.S. dollars (US$)—presented as median and interquartile range (IQR). Of 469 TB patients recruited, the mean age was 38 years and 57% were male. The median pretreatment direct cost per person was $37.51 (IQR 20.79–71.24). Hospitalization, diagnostic tests, and travel costs were predominant. Higher pretreatment costs were associated with no health insurance ($41.88 versus $27.41, < 0.001), ≥ 6 visits to a healthcare provider ($39.91 versus $24.32, < 0.001), ≥ 60 days pretreatment ($36.35 versus $26.25, = 0.02), and presenting first to a PP ($40.71) or informal provider ($32.72) compared with private hospital ($21.26), public hospital ($19.63), or CHC ($13.52) ( = 0.01). For a subsample of 106 patients with total pre- and posttreatment costs available, the median total cost was $243.66 (IQR 128.46–550.71). For 26.5% of these patients, total costs were ≥ 20% of their annual household income. Despite having a good network of free TB diagnostic and treatment services throughout Bandung, patients experienced significant out-of-pocket costs. Increased uptake of the National Health Insurance, and systems for early recognition and diagnosis of TB, will contribute toward reducing costs.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.19-0848
2020-07-06
2020-09-28
Loading full text...

Full text loading...

http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.19-0848
Loading
/content/journals/10.4269/ajtmh.19-0848
Loading

Data & Media loading...

  • Received : 11 Nov 2019
  • Accepted : 27 May 2020
  • Published online : 06 Jul 2020
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error