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Free Content Costs incurred by patients with pulmonary tuberculosis in rural India

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SETTING: Vellore District, Tamil Nadu, India.

OBJECTIVE: To measure patient costs associated with diagnosis and the complete treatment of tuberculosis (TB).

DESIGN: Prospective structured interview of 100 new smear-positive adult patients being treated for TB in Tamil Nadu, India, selected evenly from 10 representative health facilities in the state. Direct (out-of-pocket) and indirect (lost-time) costs were quantified by period of illness using a standardised questionnaire, and univariate regression investigated predictors of total cost.

RESULTS: Seventy-four per cent of patients were male, with a mean age of 40.2 years. All were given a first-line regimen, and none had been previously treated. The mean direct cost was US$34.91 (SD $46.94), the mean indirect cost was $526.87 (SD $375.71), and the total mean cost per patient was $562.66 (SD $287.48). Twenty-five patients were admitted to hospital, at a mean cost of $279.43 (SD $142.88) per admission. Variation in costs was associated with admission.

CONCLUSION: TB patients in India incur large costs associated with TB illness. The greatest single cost was time lost during admission. Total patient costs represent 193% of the estimated monthly income of a manual labourer.

Keywords: India; cost; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Community Health, Christian Medical College, Vellore, India 2: Department of Medicine, Christian Medical College, Vellore, India 3: Respiratory Epidemiology Unit, Montreal Chest Institute, Montreal, Quebec, Canada

Publication date: 2009-10-01

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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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