Tuberculosis care strategies and their economic consequences for patients: the missing link to end tuberculosis

Getahun, Belete; Wubie, Moges; Dejenu, Getiye; Manyazewal, Tsegahun

doi:10.1186/s40249-016-0187-9

Cited by 42 publications

(45 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study showed that the average OOP payment was USD 2389.5 for TB patients during the whole TB episode, which was equivalent to 27.4% of the annual household income. The proportion was higher than that in Pakistan (5.4%) [15] and lower than those in Ethiopia (152%) [21] and Nigeria (37%) [22]. Direct medical costs accounted for the majority of the costs in this population, inconsistent with other studies that showed a high proportion of non-medical costs and indirect costs [23,24].…”

Section: Interpretation Of Key Findings Oop Payments and Their Componcontrasting

confidence: 80%

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China: income inequality

Liu

Wang

et al. 2020

Infect Dis Poverty

View full text Add to dashboard Cite

Background: Despite the availability of free tuberculosis (TB) diagnosis and treatment, TB care still generates substantial costs that push people into poverty. We investigated out-of-pocket (OOP) payments for TB care and assessed the resulting economic burden and economic consequences for those with varying levels of household income in eastern China. Methods: A cross-sectional study was conducted among TB patients in the national TB programme networks in eastern China. TB-related direct OOP costs, time loss, and coping strategies were investigated across households in different economic strata. Analysis of Variance was used to examine the differences in various costs, and Kruskal-Wallis tests were used to compare the difference in total costs as a percentage of annual household income. Results: Among 435 patients, the mean OOP total costs of TB care were USD 2389.5. In the lower-income quartile, OOP payments were lower, but costs as a percentage of reported annual household income were higher. Medical costs and costs prior to treatment accounted for 66.4 and 48.9% of the total costs, respectively. The lower the household income was, the higher the proportion of medical costs to total costs before TB treatment, but the lower the proportion of medical costs patients spent in the intensive phase. TB care caused 25.8% of TB-affected households to fall below the poverty line and caused the poverty gap (PG) to increase by United States Dollar (USD) 145.6. Patients in the poorest households had the highest poverty headcount ratio (70.2%) and PG (USD 236.1), but those in moderately poor households had the largest increase in the poverty headcount ratio (36.2%) and PG (USD 177.8) due to TB care. Patients from poor households were more likely to borrow money to cope with the costs of TB care; however, there were fewer social consequences, except for food insecurity, in poor households. Conclusions: Medical and pretreatment costs lead to high costs of TB care, especially among patients from the poorest households. It is necessary to train health system staff in general hospitals to promptly identify and refer TB patients. Pro-poor programmes are also needed to protect TB patients from the medical poverty trap.

show abstract

Section: Interpretation Of Key Findings Oop Payments and Their Componcontrasting

confidence: 80%

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China: income inequality

Liu

Wang

et al. 2020

Infect Dis Poverty

View full text Add to dashboard Cite

show abstract

“…While most studies used the broad categories of strategies for coping with healthcare costs commonly covered in international household surveys (eg, using income/savings, borrowing money or selling assets) some drilled down to distinguish between types of borrowing and asset sales 19–28. For example, some studies examined who households borrowed from, noting that those forced to borrow from moneylenders faced higher interest rates than those borrowing from family or friends 25 26 28.…”

Section: Resultsmentioning

confidence: 99%

Coping with healthcare costs for chronic illness in low-income and middle-income countries: a systematic literature review

et al. 2019

View full text Add to dashboard Cite

BackgroundExperiencing illness in low-income and middle-income countries (LMICs) can incur very high out-of-pocket (OOP) payments for healthcare and, while the existing literature typically focuses on levels of expenditure, it rarely examines what happens when households do not have the necessary money. Some will adopt one or more ‘coping strategies’, such as borrowing money, perhaps at exorbitant interest rates, or selling assets, some necessary for their future income, with detrimental long-term effects. This is particularly relevant for chronic illnesses that require consistent, long-term OOP payments. We systematically review the literature on strategies for financing OOP costs of chronic illnesses in LMICs, their correlates and their impacts on households.MethodsWe searched MEDLINE, EconLit, EMBASE, Global Health and Scopus on 22 October 2018 for literature published on or after 1 January 2000. We included qualitative or quantitative studies describing at least one coping strategy for chronic illness OOP payments in a LMIC context. Our narrative review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines.ResultsForty-seven papers were included. Studies identified coping strategies for chronic illness costs that are not traditionally addressed in financial risk protection research (eg, taking children out of school, sending them to work, reducing expenditure on food or education, quitting work to give care). Twenty studies reported socioeconomic or other correlates of coping strategies, with poorer households and those with more advanced disease more vulnerable to detrimental strategies. Only six studies (three cross-sectional and three qualitative) included evidence of impacts of coping strategies on households, including increased labour to repay debts and discontinuing treatment.ConclusionsMonitoring of financial risk protection provides an incomplete picture if it fails to capture the effect of coping strategies. This will require qualitative and longitudinal research to understand the long-term effects, especially those associated with chronic illness in LMICs.

show abstract

“…In this study, the lower recovery rate of TB and lowerlevel Medical insurance coverage are both lead to The long-term existence of the source of infection, which is similar to the results of recent studies. [37,38] The situation of failed TB treatment and out-of-pocket payments with catastrophic consequences will hamper the efforts to end TB.…”

Section: Discussionmentioning

confidence: 99%

Detecting spatiotemporal pattern of tuberculosis and the relationship between ecological environment and tuberculosis, a spatial panel data analysis in Guangxi, China

Lin

Chongsuvivatwong

et al. 2018

Preprint

View full text Add to dashboard Cite

Guangxi is one of the provinces having the highest reported incidence of tuberculosis (TB) in China. However, spatial and temporal pattern and causation of the situation are still unclear. In order to detect the spatiotemporal pattern of TB and the association with ecological environment factors in Guangxi Zhuang autonomous region, China, We performed a spatiotemporal analysis with prediction using time series analysis, Moran's I global and local spatial autocorrelation statistics, and space-time scan statistics, to detect temporal and spatial clusters. Spatial panel models were employed to identify the influence factors. The time series analysis shows that the number of reported cases peaked in spring and summer and decreased in autumn and winter with the annual reported incidence of 113.1/100,000 population. Moran's I global statistics were greater than 0 (0.363 -0.536) during the study period. The most significant hot spots were mainly located in the central part. The east part exhibited a low-low relation. By spacetime scanning, the clusters identified were similar to that of the local autocorrelation statistics, and were clustered toward the early of 2016. Duration of sunshine, per capita gross domestic product (PGDP), the recovery rate of TB and participation rate of new cooperative medical care insurance in rural areas had a significant negative association with TB. In conclusion, the reported incidence of TB in Guangxi remains high. The main cluster was located in the central part of Guangxi, a region where promoting the productivity, improving TB treatment pathway and strengthening environmental protective measures (increasing sunshine exposure) are urgently needed.

show abstract

Tuberculosis care strategies and their economic consequences for patients: the missing link to end tuberculosis

Cited by 42 publications

References 22 publications

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China: income inequality

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China: income inequality

Coping with healthcare costs for chronic illness in low-income and middle-income countries: a systematic literature review

Detecting spatiotemporal pattern of tuberculosis and the relationship between ecological environment and tuberculosis, a spatial panel data analysis in Guangxi, China

Contact Info

Product

Resources

About