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Free Content Causes and costs of hospitalization of tuberculosis patients in the United States

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OBJECTIVE: To examine the costs, lengths of stay and patient characteristics associated with tuberculosis (TB) hospitalizations.

METHODS: A prospective cohort study of 1493 TB patients followed from diagnosis to completion of therapy at 10 public health programs and area hospitals in the US. The main outcome measures were the following: 1) occurrence, 2) cost, and 3) length of stay of TB-related hospitalizations.

RESULTS: There were 821 TB-related hospitalizations among the study participants; 678 (83%) were initial hospitalizations and 143 (17%) were hospitalizations during the treatment of TB. Patients infected with human immunodeficiency virus (HIV) (OR 1.8, 95%CI 1.2–2.6), and homeless patients (OR, 1.7 95%CI 1.1–2.8) were at increased risk of being hospitalized at diagnosis. Homeless patients (RR 2.5, 95%CI 1.5–4.3), patients who used alcohol excessively (RR 1.9, 95%CI 1.2–3.0), and patients with multidrug-resistant TB (RR 5.7, 95%CI 2.7–11.8) were at increased risk of hospitalization during treatment. The median length of stay varied from 9 to 17 days, and median costs per hospitalization varied from $6441 to $12968 among the sites.

CONCLUSION: Important social factors, HIV infection, and local hospitalization practice patterns contribute significantly to the high cost of TB-related hospitalizations. Efforts to address these specific factors are needed to reduce the cost of preventable hospitalizations.
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Keywords: costs; hospitalization; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Tuberculosis Elimination, National Center for HIV, STD & TB Prevention, Atlanta, Georgia, USA 2: Fort Worth-Tarrant County Public Health Department, Tuberculosis Elimination/Control, Fort Worth, Texas, USA 3: Bureau of Tuberculosis Control, New York State Department of Health, Albany, New York, USA

Publication date: October 1, 2000

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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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