Tuberculosis Costs in Spain and Related Factors

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• 作者：José ; Antonio Gulló ; n^a ; ^d ; ^{josegubl@gmail.com} ; José ; Marí ; a Garcí ; a-Garcí ; a^a ; ^d ; Manuel Á ; ngel Villanueva^a ; Fernando Á ; lvarez-Navascues^a ; Teresa Rodrigo^b ; ^d ; ^e ; Martí ; Casals^d ; ^e ; Luis Anibarro^d ; ^f ; Marta Marí ; a Garcí ; a-Clemente^d ; ^g ; Marí ; a Á ; ngeles Jimé ; nez^d ; ^h ; Ana Bustamante^d ; ⁱ ; Antó ; n Penas^d ; ^j ; José ; Antonio Caminero^d ; ^k ; Joan Caylà ; ^c ; ^d ; Tuberculosis Research Integrated Program Working Group (PIITB)¹
• 关键词：Tuberculosis ; Hospital income ; Cost analysis
• 刊名：Archivos de Bronconeumología (English Edition)
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：52
• 期：12
• 页码：583-589
• 全文大小：545 K
• 卷排序：52

文摘

To analyze the direct and indirect costs of diagnosis and management of tuberculosis (TB) and associated factors.Patients and methodsProspective study of patients diagnosed with TB between September 2014 and September 2015. We calculated direct (hospital stays, visits, diagnostic tests, and treatment) and indirect (sick leave and loss of productivity, contact tracing, and rehabilitation) costs. The following cost-related variables were compared: age, gender, country of origin, hospital stays, diagnostic testing, sensitivity testing, treatment, resistance, directed observed therapy (DOT), and days of sick leave. Proportions were compared using the chi-squared test and significant variables were included in a logistic regression analysis to calculate odds ratio (OR) and corresponding 95% confidence intervals.Results319 patients were included with a mean age of 56.72±20.79 years. The average cost was €10,262.62±14,961.66, which increased significantly when associated with hospital admission, polymerase chain reaction, sputum smears and cultures, sensitivity testing, chest computed tomography, pleural biopsy, drug treatment longer than nine months, DOT and sick leave. In the multivariate analysis, hospitalization (OR=96.8; CI 29–472), sensitivity testing (OR=4.34; CI 1.71–12.1), chest CT (OR=2.25; CI 1.08–4.77), DOT (OR=20.76; CI 4.11–148) and sick leave (OR=26.9; CI 8.51–122) showed an independent association with cost.ConclusionTuberculosis gives rise to significant health spending. In order to reduce these costs, more control of transmission, and fewer hospital admissions would be required.