Is convenience really king? Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam: a longitudinal patient cost study

Autor: Hoa Binh Nguyen, Luan Nguyen Quang Vo, Rachel Jeanette Forse, Anja Maria Christine Wiemers, Huy Ba Huynh, Thuy Thi Thu Dong, Yen Thi Hoang Phan, Jacob Creswell, Thi Minh Ha Dang, Lan Huu Nguyen, Jad Shedrawy, Knut Lönnroth, Tuan Dinh Nguyen, Luong Van Dinh, Kristi Sidney Annerstedt, Andrew James Codlin
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Infectious Diseases of Poverty, Vol 13, Iss 1, Pp 1-12 (2024)
Druh dokumentu: article
ISSN: 2049-9957
DOI: 10.1186/s40249-024-01196-2
Popis: Abstract Background In Viet Nam, tuberculosis (TB) represents a devastating life-event with an exorbitant price tag, partly due to lost income from daily directly observed therapy in public sector care. Thus, persons with TB may seek care in the private sector for its flexibility, convenience, and privacy. Our study aimed to measure income changes, costs and catastrophic cost incurrence among TB-affected households in the public and private sector. Methods Between October 2020 and March 2022, we conducted 110 longitudinal patient cost interviews, among 50 patients privately treated for TB and 60 TB patients treated by the National TB Program (NTP) in Ha Noi, Hai Phong and Ho Chi Minh City, Viet Nam. Using a local adaptation of the WHO TB patient cost survey tool, participants were interviewed during the intensive phase, continuation phase and post-treatment. We compared income levels, direct and indirect treatment costs, catastrophic costs using Wilcoxon rank-sum and chi-squared tests and associated risk factors between the two cohorts using multivariate regression. Results The pre-treatment median monthly household income was significantly higher in the private sector versus NTP cohort (USD 868 vs USD 578; P = 0.010). However, private sector treatment was also significantly costlier (USD 2075 vs USD 1313; P = 0.005), driven by direct medical costs which were 4.6 times higher than costs reported by NTP participants (USD 754 vs USD 164; P
Databáze: Directory of Open Access Journals
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