Pre-treatment delay and out of pocket expenses by notified new tuberculosis patients in an Indian mega city
| Autor: | P. Praseeja, G. Umadevi, Lakshmi Narayana, B.A. Shivashankar, R.K. Jaiswal, G. Puttaswamy, N. Nagendra, R. Padmesha, Vineet K. Chadha, P. Suganthi, V. Magesh, Narasimhaiah Somashekar, N.K. Hemanth Kumar, Ratan K Srivastava |
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| Rok vydání: | 2022 |
| Předmět: |
Male
Pre treatment medicine.medical_specialty Tuberculosis business.industry Public health Dissaving medicine.disease Time-to-Treatment Medical expenditure Infectious Diseases Asian People Health facility Outpatients Total delay medicine Humans Household income Female Health Expenditures business Demography |
| Zdroj: | Indian Journal of Tuberculosis. 69:446-452 |
| ISSN: | 0019-5707 |
| DOI: | 10.1016/j.ijtb.2021.07.001 |
| Popis: | Background Study was carried out to find out delay from onset of symptoms and out of pocket expenditure (OOPE) until initiation of anti-TB treatment (ATT) by new Tuberculosis (TB) patients registered in public health facilities in Bengaluru. Methods Notified patients (N = 228) selected purposively were interviewed at initiation of ATT regarding number and type of facilities visited and delay in initiating ATT. OOPE was elicited separately for in- and out-patient visits, towards consultation, purchase of medicines, diagnostic tests, transportation, hospitalization and food. Dissaving or money borrowed was ascertained. Results Two-thirds of participants were 15–44 years of age and 56% were males, mean annual household income was $4357. About 75% first visited a private health facility; 68% and 87% respectively were diagnosed and started on ATT in public sector after visiting an average of three facilities and after a mean delay of 68 days; the median delay was 44 days. Of mean OOPE of $402, 54% was direct medical expenditure, 5% non-medical direct and 41% indirect. OOPE was higher for Extra-pulmonary TB compared to PTB and when number of health facilities visited before initiating treatment was >3 compared to those who visited ≤3 and when the time interval between onset of symptoms and treatment initiation (total delay) was >28 days compared to when this interval was ≤28 days. About 20% suffered catastrophic expenditure; 34% borrowed money and 37% sold assets. Conclusion Concerted efforts are needed to reduce delay and OOPE in pre-treatment period and social protection to account for indirect expenditure. |
| Databáze: | OpenAIRE |
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