José Antonio Gullón1, José María García-García2, Manuel Ángel Villanueva3, Fernando Álvarez-Navascues3, Teresa Rodrigo4, Martí Casals5, Luis Anibarro6, Marta María García-Clemente7, María Ángeles Jiménez8, Ana Bustamante9, Antón Penas10, José Antonio Caminero11, Joan Caylà12. 1. Unidad de Gestión Clínica, Neumología, Hospital San Agustín, Avilés, Asturias, España; Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España. Electronic address: josegubl@gmail.com. 2. Unidad de Gestión Clínica, Neumología, Hospital San Agustín, Avilés, Asturias, España; Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España. 3. Unidad de Gestión Clínica, Neumología, Hospital San Agustín, Avilés, Asturias, España. 4. Fundación Respira, Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Barcelona, España; Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, España. 5. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, España. 6. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Hospital Universitario de Pontevedra, Pontevedra, España. 7. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Hospital Universitario Central de Asturias, Oviedo, Asturias, España. 8. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Hospital Universitario Val D'Hebrón, Barcelona, España. 9. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Hospital Sierrallana, Torrelavega, Cantabria, España. 10. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Hospital Universitario Lucus Augusti, Lugo, España. 11. Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España; Complejo Hospitalario Dr. Negrín, Las Palmas de Gran Canaria, España. 12. Agencia de Salud Pública de Barcelona, Barcelona, España; Programa Integrado de Investigación en Tuberculosis (PIITB) de SEPAR, Barcelona, España.
Abstract
OBJECTIVE: To analyze the direct and indirect costs of diagnosis and management of tuberculosis (TB) and associated factors. PATIENTS AND METHODS: Prospective 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. RESULTS: 319 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, sensitvity 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. CONCLUSION: Tuberculosis gives rise to significant health spending. In order to reduce these costs, more control of transmission, and fewer hospital admissions would be required. Copyright Â
OBJECTIVE: To analyze the direct and indirect costs of diagnosis and management of tuberculosis (TB) and associated factors. PATIENTS AND METHODS: Prospective 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. RESULTS: 319 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, sensitvity 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. CONCLUSION:Tuberculosis gives rise to significant health spending. In order to reduce these costs, more control of transmission, and fewer hospital admissions would be required. Copyright Â
Authors: Giovanni Battista Migliori; Dina Visca; Martin van den Boom; Simon Tiberi; Denise Rossato Silva; Rosella Centis; Lia D'Ambrosio; Tania Thomas; Emanuele Pontali; Laura Saderi; H Simon Schaaf; Giovanni Sotgiu Journal: Pulmonology Date: 2021-01-28