Cost determinants of tuberculosis management in a low-prevalence country

M. Bocchino, S. Greco, Y. Rosati, G. Mattioli, A. Marruchella, P. De Mori, C. Bibbolino, E. Girardi, S. Squarcione, Cesare Saltini

Research output: Contribution to journalArticlepeer-review

Abstract

SETTING: Division of respiratory medicine in a specialised infectious disease hospital in Rome, Italy. OBJECTIVE: Retrospective evaluation of tuberculosis (TB) care associated costs in an integrated in- and outpatient management programme. DESIGN: Review of the medical records of 92 human immunodeficiency virus negative TB cases admitted between September 2000 and May 2003. RESULTS: Length of in-hospital stay (45 ± 35 days) was the major cost determinant, as hospitalisation accounted for almost 80% of the total costs of the case, with fixed bed-per-day charges amounting to 76% of hospital costs. Factors associated with higher costs were chest X-ray score, fever, sputum bacterial load and multidrug resistance (P <0.05). Cure/treatment completion was achieved in 82% of patients entering the out-patient programme (63% of all cases). Homelessness, age and comorbidities were associated with unfavourable outcomes. CONCLUSIONS: A closely followed hospital-centred protocol carried out in a high-resource setting may produce acceptable cure/completion treatment rates. As a too high fraction of resources invested in TB control goes toward hospital costs, out-patient treatment strategies should be implemented.

Original languageEnglish
Pages (from-to)146-152
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume10
Issue number2
Publication statusPublished - Feb 2006

Keywords

  • Case outcome
  • Costs
  • Hospital care
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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