Catastrophic costs incurred by tuberculosis affected households from Thailand's first national tuberculosis patient cost survey.

Autor: Youngkong S; Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand. sitaporn.you@mahidol.edu.; Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. sitaporn.you@mahidol.edu., Kamolwat P; Division of Tuberculosis, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand., Wongrot P; Faculty of Nursing, Mahidol University, Nakhon Pathom, Thailand., Thavorncharoensap M; Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.; Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand., Chaikledkaew U; Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.; Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand., Nateniyom S; Division of Tuberculosis, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand., Pungrassami P; Division of Tuberculosis, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand., Praditsitthikorn N; Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand., Mahasirimongkol S; Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand., Jittikoon J; Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand., Nishikiori N; World Health Organization Global Tuberculosis Programme, Geneva, Switzerland., Baena IG; World Health Organization Global Tuberculosis Programme, Geneva, Switzerland., Yamanaka T; World Health Organization Global Tuberculosis Programme, Geneva, Switzerland.; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 May 16; Vol. 14 (1), pp. 11205. Date of Electronic Publication: 2024 May 16.
DOI: 10.1038/s41598-024-56594-1
Abstrakt: Tuberculosis (TB) causes an economic impact on the patients and their households. Although Thailand has expanded the national health benefit package for TB treatment, there was no data on out-of-pocket payments and income losses due to TB from patients and their household perspectives. This national TB patient cost survey was conducted to examine the TB-related economic burden, and assess the proportion of TB patients and their households facing catastrophic total costs because of TB disease. A cross-sectional TB patient cost survey was employed following WHO methods. Structured interviews with a paper-based questionnaire were conducted from October 2019 to July 2021. Both direct and indirect costs incurred from the patient and their household perspective were valued in 2021 and estimated throughout pre- and post-TB diagnosis episodes. We assessed the proportion of TB-affected households facing costs > 20% of household expenditure due to TB. We analyzed 1400 patients including 1382 TB (first-line treatment) and 18 drug-resistant TB patients (DR-TB). The mean total costs per TB episode for all study participants were 903 USD (95% confident interval; CI 771-1034 USD). Of these, total direct non-medical costs were the highest costs (mean, 402 USD, and 95%CI 334-470 USD) incurred per TB-affected household followed by total indirect costs (mean, 393 USD, and 95%CI 315-472 USD) and total direct medical costs (mean, 107 USD, and 95%CI 81-133 USD, respectively. The proportion of TB-affected households facing catastrophic costs was 29.5% (95%CI 25.1-34.0%) for TB (first-line), 61.1% (95%CI 29.6-88.1%) for DR-TB and 29.9% (95%CI 25.6-34.4%) overall. This first national survey highlighted the economic burden on TB-affected households. Travel, food/nutritional supplementation, and indirect costs contribute to a high proportion of catastrophic total costs. These suggest the need to enhance financial and social protection mechanisms to mitigate the financial burden of TB-affected households.
(© 2024. The Author(s).)
Databáze: MEDLINE
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