The economic burden of tuberculosis in Sistan: a high‐risk region in Iran

Setoodehzadeh, Fatemeh; Barfar, Eshagh; Ansari, Hossein; Sari, Ali Akbari; Azizi, Najmeh

doi:10.1111/tmi.13570

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…When patients receive only junior middle school education, they will be more aware of seeing a doctor and pay more attention to health than illiterate patients [ 45 ]. However, compared with patients with higher education, patients with junior middle school education may not better understand hospital procedures and medical knowledge [ 46 ]. As a result, patients with a junior high school education may spend more money before diagnosis and during treatment.…”

Section: Discussionmentioning

confidence: 99%

Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

et al. 2023

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Background Although diagnosis and treatment services for tuberculosis (TB) are provided free of charge in most countries, direct non-medical and indirect costs due to absenteeism, also place a significant burden on patients and their families. Sichuan Province has the second highest incidence of TB in China, with an incidence of approximately 100 cases per 100 000 people. However, there are limited research on out-of-pocket expenditure (OOPE) and its influencing factors in TB patients in Sichuan Province. Methods A retrospective cross-sectional study was conducted on TB patients in designated medical institutions for TB in Sichuan Province from 2017-2021. A face-to-face questionnaire was conducted to obtain the information related to hospitalization of patients, and the multi-level regression model was used to analyse the factors that influence OOPE and total out-of-pocket expenditure (TOOPE) of TB patients. Results A total of 2644 patients were investigated, and 74.24% of TB patients and their families experienced catastrophic total costs due to TB. The median total cost was 9223.37 CNY (1429.98 USD), in which the median direct and indirect costs of TB patients were 10185.00 CNY (1579.07 USD) and 2400.00 CNY (372.09 USD), respectively, and indirect costs contributed to 43% of total costs. The median OOPE and TOOPE costs were 6024.00 CNY (933.95 USD) and 11890.50 CNY (1843.49 USD), respectively. OOPE and TOOPE had common influencing factors including whether the patient's family had four or more members, a history of hospitalization, combination with other types of TB, the number of visits before diagnosis, and co-occurrence with chronic disease. Conclusions The OOPE and TOOPE for TB patients and their families in Sichuan Province are still heavy. In the long run, it is necessary to strengthen education and awareness campaigns on TB related knowledge, disseminate basic medical knowledge to the public, improve healthcare-seeking behavior, and enhance the healthcare infrastructure to improve the accuracy of TB diagnosis and reduce the significant OOPE and TOOPE faced by TB patients and their families in Sichuan Province.

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Section: Discussionmentioning

confidence: 99%

Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

et al. 2023

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Health insurance’s contribution to reducing the financial burden of tuberculosis in Guizhou Province, China

Du,

Ma,

Huang

et al. 2024

Epidemiol. Infect.

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Despite global efforts to end tuberculosis (TB), the goal of preventing catastrophic health expenditure (CHE) due to TB remains unmet. This cross-sectional study was conducted in Guizhou Province, Southwest China. Data were collected from the Hospital Information System and a survey of TB patients who had completed standardized antituberculosis treatment between January and March 2021. Among the 2 283 participants, the average total expenditure and out-of-pocket expenditure were $1 506.6 (median = $760.5) and $683.6 (median = $437.8), respectively. Health insurance reimbursement reduced CHE by 16.8%, with a contribution rate of 24.9%, and the concentration index changed from -0.070 prereimbursement to -0.099 postreimbursement. However, the contribution of health insurance varied significantly across different economic strata, with contribution rates of 6.4% for the lowest economic group and 53.1% for the highest group. For patients from lower socioeconomic strata, health insurance contributed 10.7% to CHE in the prediagnostic phase and 23.5% during treatment. While social health insurance alleviated the financial burden for TB patients, it did not provide sufficient protection for those in lower economic strata or during the prediagnostic stage. This study underscores the need for more effective and equitable subsidy policies for TB patients .

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Estimating the impact of the first 2 years of the COVID-19 pandemic on tuberculosis diagnosis and treatment outcomes in Southeastern City in Iran: an interrupted time series analysis of the preceding 10 years of ecological data

Sharafi,

TalebiMoghaddam,

Narouee

et al. 2024

BMC Health Serv Res

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Background With shared modes of transmission and clinical symptoms the convergence of COVID-19 and tuberculosis (TB) might lead to reduced diagnosis and detection of TB, which is challenging for healthcare systems already strained by the pandemic's reach. Methods This ecological study investigated the impact of the COVID-19 pandemic on TB surveillance over the first 2 years of the pandemic (March 2020 to February 2022) in southeastern Iran. Interrupted Time Series (ITS) analysis with the quasi-Poisson regression models was used to estimate the relative risk (RR) of TB diagnosis and treatment outcome counts, stratified by gender, case definition, involvement type, and treatment outcomes. Results The ITS analyses showed a significant decrease in TB total cases (RR: 0.622 [95% CI: 0.487, 0.793], P < 0.001), new cases (RR: 0.632 [95% CI: 0.493, 0.810], P < 0.001) and recurrent cases (RR: 0.491 [95% CI: 0.247, 0.974], P < 0.001). In addition, recovery and treatment failure counts also showed significant decreases (RR: 0.751 [95% CI: 0.566, 0.996], P = 0.05; RR: 0.201 [95% CI: 0.054, 0.738], P = 0.02). Moreover, significant decreases are observed in both genders and involvement types (pulmonary and extrapulmonary TB). No significant change was observed for absent to treatment and death counts. Conclusion The COVID-19 pandemic has negatively impacted TB diagnosis and treatments. Concerns are risen about the progress achieved in TB control.

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The economic burden of tuberculosis in Sistan: a high‐risk region in Iran

Cited by 4 publications

References 30 publications

Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

Assessing the influencing factors of out-of-pocket costs on tuberculosis in Sichuan Province: a cross-sectional study

Health insurance’s contribution to reducing the financial burden of tuberculosis in Guizhou Province, China

Estimating the impact of the first 2 years of the COVID-19 pandemic on tuberculosis diagnosis and treatment outcomes in Southeastern City in Iran: an interrupted time series analysis of the preceding 10 years of ecological data

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