Health-Care Expenditures for Tuberculosis in the United States

Brown, Ruth E.; Miller, Bess; Taylor, William R.; Palmer, Cynthia S.; Bosco, Lynn; Nicola, Ray M.; Zelinger, Jerry; Simpson, Kit N.

doi:10.1001/archinte.1995.00430150057006

Cited by 94 publications

(20 citation statements)

References 22 publications

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“…Hospitalization frequencies and LOS in our study were comparable to other US and Canadian studies [12, 14, 21]. In the one US study to differentiate initial and during-treatment hospitalizations, Taylor found that 45% of TB patients had an initial hospitalization for TB and 8% were hospitalized during treatment, with a median LOS of 11 days [14].…”

Section: Discussionsupporting

confidence: 85%

Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study

et al. 2016

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BackgroundHospitalization is the most costly health system component of tuberculosis (TB) control programs. Our objectives were to identify how frequently patients are hospitalized, and the factors associated with hospitalizations and length-of-stay (LOS) of TB patients in a large Canadian city.MethodsWe extracted data from the Montreal TB Resource database, a retrospective cohort of all active TB cases reported to the Montreal Public Health Department between January 1996 and May 2007. Data included patient demographics, clinical characteristics, and dates of treatment and hospitalization. Predictors of hospitalization and LOS were estimated using logistic regression and Cox proportional hazards regression, respectively.ResultsThere were 1852 active TB patients. Of these, 51% were hospitalized initially during the period of diagnosis and/or treatment initiation (median LOS 17.5 days), and 9.0% hospitalized later during treatment (median LOS 13 days). In adjusted models, patients were more likely to be hospitalized initially if they were children, had co-morbidities, smear-positive symptomatic pulmonary TB, cavitary or miliary TB, and multi- or poly-TB drug resistance. Factors predictive of longer initial LOS included having HIV, renal disease, symptomatic pulmonary smear-positive TB, multi- or poly-TB drug resistance, and being in a teaching hospital.ConclusionsWe found a high hospitalization rate during diagnosis and treatment of patients with TB. Diagnostic delay due to low index of suspicion may result in patients presenting with more severe disease at the time of diagnosis. Earlier identification and treatment, through interventions to increase TB awareness and more targeted prevention programs, might reduce costly TB-related hospital use.

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Section: Discussionsupporting

confidence: 85%

Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study

et al. 2016

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“…Our estimated cost of investigating a contact ($250) is slightly lower than other estimates (~$300) 23,24. If the investigation costs are higher than our estimated costs, the CPM would be even more cost-effective.…”

Section: Discussioncontrasting

confidence: 54%

“…A full course (6 months) and a partial course of INH treatment were estimated to cost $13.80 and $6.90, respectively. The treatment of active TB disease was estimated to cost $12 160, which represented a weighted average of inpatient ($14 777) and outpatient ($4 774) costs 13,20,23–25…”

Section: Methodsmentioning

confidence: 99%

Targeted Tuberculosis Contact Investigation Saves Money Without Sacrificing Health

Pisu

Gerald

Shamiyeh

et al. 2009

Journal of Public Health Management and Practice

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“…In 1991 dollars, the initial hospitalization for these patients is estimated to have cost у$18,588/hospitalization. The total-cost estimate, $3.0 million, is likely an underestimate, since the median duration of hospitalization for the study patients was 34 days, compared with the 20 days reported by Brown et al [22]. In addition, during the course of TB treatment, there were an additional 207 hospitalizations comprising 8627 days.…”

Section: Discussionmentioning

confidence: 99%

Persistence of a Highly Resistant Strain of Tuberculosis in New York City during 1990–1999

et al. 2003

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One multidrug-resistant Mycobacterium tuberculosis (MDRTB) strain, strain W, caused several nosocomial outbreaks in New York City (NYC) during 1 January 1990-31 July 1993. We reviewed all MDRTB cases verified during 1 August 1993-31 December 1999 that had isolates with either this DNA pattern or a variant of this strain, and we compared them to the outbreak cases. Of 427 DNA-confirmed cases from 1990-1999, 161 (37%) were from 1 August 1993-31 December 1999; these 161 cases, from 56 hospitals and 2 correctional sites, constituted 28% of all MDRTB cases in NYC during this period. Compared with those from 1 January 1990-31 July 1993, patients from 1 August 1993-31 December 1999 were less likely to be infected with human immunodeficiency virus, to have been born in the United States, to be homeless, to have been incarcerated, and to have epidemiological links; 16% of patients had nosocomial- and 9% had community-exposure links. This strain was disseminated widely in the community during the outbreaks; postoutbreak cases likely represent reactivated disease among individuals infected during the outbreak periods in the community.

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Health-Care Expenditures for Tuberculosis in the United States

Cited by 94 publications

References 22 publications

Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study

Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study

Targeted Tuberculosis Contact Investigation Saves Money Without Sacrificing Health

Persistence of a Highly Resistant Strain of Tuberculosis in New York City during 1990–1999

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