Cost analysis of paediatric tuberculosis treatment in Japan
Abstract: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.
Document Type: Regular Paper
Publication date: March 1, 2003
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