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Free Content Cost analysis of paediatric tuberculosis treatment in Japan

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OBJECTIVE: To estimate the cost of treating a tuberculosis (TB) case and to analyse TB-related medical service utilisation, a cost-of-illness study was conducted for all patients with a primary diagnosis of TB admitted to a public hospital in Japan.

METHODS: Retrospective analysis by abstracting in- and out-patient medical records of 57 paediatric patients diagnosed with TB during 1993–1998 at a public hospital in Osaka prefecture. Costs were estimated based on third partyÕs payer perspectives according to the service utilisation pattern. In addition to cost data, socio-demographic information and service utilisation pattern were also extracted from the medical records. Cost of preventing a case of TB was abstracted from the published literature.

RESULTS: The average cost of treatment was US$8384 (95%CI 5667–11099), while the average length of hospitalisation was 63 days (95%CI 43–84). Based on 20–80% vaccine efficacy, the cost of preventing a case of TB was US$35 950–175862. In univariate analysis, site of TB (P = 0.04) was significantly associated with TB treatment cost, while case-finding method (contact tracing, symptoms, etc.) was associated with length of hospitalisation (P = 0.03). Multivariate regression analysis, however, showed none of the factors to be significant predictors of TB treatment cost and length of hospital stay.

CONCLUSION: The cost of treating a case of paediatric TB is much lower than that of preventing one. JapanÕs universal BCG vaccination policy should be re-examined in the light of economic, social and political issues.
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Keywords: Bacillus Calmette-Guérin; Japan; costs; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of General Medicine and Clinical Epidemiology, Kyoto University, Kyoto, Japan 2: Department of Paediatrics, Osaka Prefectural Habikino Hospital, Osaka, Japan

Publication date: 2003-03-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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