Costs and Coping Strategies of Tuberculosis Inpatients in Tertiary Care Hospital Settings in Lahore, Pakistan

Background: Despite free treatment and screening programs, Tuberculosis can reduce the working capability of patients due to the costs they incur. Eventually, it can lead to economic crises in low- and middle-income countries with a high prevalence of Tuberculosis. The objectives were to look into the costs incurred by Tuberculosis patients and to determine the coping strategies they adopted while admitted to the Hospitals for treatment of Tuberculosis. Methods: In this cross-sectional study, data was collected using an adapted questionnaire based on World Health Organization’s TB patient cost survey protocol. The study was conducted in two tertiary care hospitals in Lahore from November to December 2019. In all 309 TB patients admitted in these hospitals were administered the questionnaire. The data was analyzed with SPSS version 23 software. Results: The estimated direct medical costs per TB patient were 42,106.7 Pakistani Rupees ($271.65). Indirect costs per patient were double of this i.e. 76,013.4 Pakistani Rupees ($490.40). About 65.3 % of patients suffered Catastrophic Health Expenditure with a significant difference between the household income before and during TB treatment. About 52.10% of total patients borrowed money from others and 28.76% sold their assets for meeting the costs incurred. Conclusion: Disparities in household income and treatment total costs lead to a decrease in financial risk protection of TB inpatients. A multi-sectoral approach may help cope with the costs of patients and increase the knowledge of newly diagnosed TB patients to decrease the incidence and achieve the END TB goals by 2035.