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Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China

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  • Yixiang Huang
  • Jianying Huang
  • Xiaoting Su
  • Liang Chen
  • Jianwei Guo
  • Weiqing Chen
  • Lingling Zhang

Abstract

Background: Illness-related costs experienced by tuberculosis patients produce a severe economic impact on households, especially poor families. Few studies have investigated the full costs, including direct and indirect costs, at the patient and household levels in south-east China. Methods: A case follow-up study was conducted in the Bao'an district of Shenzhen City, China. Eligible new and previously treated individuals with pulmonary tuberculosis (TB) during January 1st 2013 to June 30th 2013 were enrolled. Medical and non-medical costs as well as income loss were calculated in diagnosis and treatment periods, respectively. Factors associated with costs due to TB diagnosis, treatment and TB care (diagnosis + treatment) were explored respectively with a linear regression model. Results: Of the total 514 TB patients enrolled, 95% were from the migrant population, and 65% were males, with a mean age of 32.25 (±10.11). The median costs due to TB diagnosis and TB treatment were 79 United States dollar (USD), 748USD (6.2897 China Yuan (CNY) = 1USD, 2013) per patient, respectively. The median costs due to TB care (diagnosis and treatment) per patient was 1218USD, corresponding to 26% of patients’ annual income pre-illness. Those who visited more times to health facilities, hospitalized, received higher education, or occupied in national civil servant/services/retired staff might expense more before diagnosis. Costs due to TB treatment was significantly higher among migrant patients, sputum smear positive patients, and widowed/divorced population. Factors associated with less total costs were native patients, fewer times of visiting to health-care facilities and those with no hospitalization history due to TB. Conclusions: Although a free TB control policy is in force, patients with TB are still facing a heavy economic burden. More available interventions to reduce the financial burden on tuberculosis patients are urgently needed.

Suggested Citation

  • Yixiang Huang & Jianying Huang & Xiaoting Su & Liang Chen & Jianwei Guo & Weiqing Chen & Lingling Zhang, 2020. "Analysis of the economic burden of diagnosis and treatment on patients with tuberculosis in Bao’an district of Shenzhen City, China," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0237865
    DOI: 10.1371/journal.pone.0237865
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    References listed on IDEAS

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    1. Qi Zhao & Lixia Wang & Tao Tao & Biao Xu, 2013. "Impacts of the “transport subsidy initiative on poor TB patients” in Rural China: A Patient-Cohort Based Longitudinal Study in Rural China," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    2. Pimwara Tanvejsilp & Mark Loeb & Jonathan Dushoff & Feng Xie, 2018. "Healthcare Resource Uses and Out-of-Pocket Expenses Associated with Pulmonary TB Treatment in Thailand," PharmacoEconomics - Open, Springer, vol. 2(3), pages 297-308, September.
    3. Sangsang Qiu & Hongqiu Pan & Simin Zhang & Xianzhen Peng & Xianzhi Zheng & Guisheng Xu & Min Wang & Jianming Wang & Hui Lu, 2015. "Is Tuberculosis Treatment Really Free in China? A Study Comparing Two Areas with Different Management Models," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
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