Patients direct costs to undergo TB diagnosis

Rachel M Anderson de Cuevas; Lovett Lawson; Najla Al-Sonboli; Nasher Al-Aghbari; Isabel Arbide; Jeevan B Sherchand; Emenyonu E Nnamdi; Abraham Aseffa; Mohammed A Yassin; Saddiq T Abdurrahman; Joshua Obasanya; Oladimeji Olanrewaju; Daniel Datiko; Sally J Theobald; Andrew Ramsay; S Bertel Squire; Luis E Cuevas

doi:10.1186/s40249-016-0117-x

Patients direct costs to undergo TB diagnosis

Rachel M Anderson de Cuevas, Lovett Lawson, Najla Al-Sonboli, Nasher Al-Aghbari, Isabel Arbide, Jeevan B Sherchand, Emenyonu E Nnamdi, Abraham Aseffa, Mohammed A Yassin, Saddiq T Abdurrahman, Joshua Obasanya, Oladimeji Olanrewaju, Daniel Datiko, Sally J Theobald, Andrew Ramsay, S Bertel Squire, Luis E Cuevas

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.

METHODS: We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure.

RESULTS: The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy.

CONCLUSIONS: The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

Original language	English
Pages (from-to)	24
Journal	Infectious Diseases of Poverty
Volume	5
DOIs	https://doi.org/10.1186/s40249-016-0117-x
Publication status	Published - 24 Mar 2016

Keywords

Adult
Aged
Cost of Illness
Female
Health Expenditures
Humans
Male
Middle Aged
Nepal
Nigeria
Prospective Studies
Rural Population
Tuberculosis/diagnosis
Yemen
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s40249-016-0117-x

Cite this

de Cuevas, R. M. A., Lawson, L., Al-Sonboli, N., Al-Aghbari, N., Arbide, I., Sherchand, J. B., Nnamdi, E. E., Aseffa, A., Yassin, M. A., Abdurrahman, S. T., Obasanya, J., Olanrewaju, O., Datiko, D., Theobald, S. J., Ramsay, A., Squire, S. B., & Cuevas, L. E. (2016). Patients direct costs to undergo TB diagnosis. Infectious Diseases of Poverty, 5, 24. https://doi.org/10.1186/s40249-016-0117-x

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title = "Patients direct costs to undergo TB diagnosis",

abstract = "BACKGROUND: A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.METHODS: We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure.RESULTS: The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy.CONCLUSIONS: The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.",

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author = "{de Cuevas}, {Rachel M Anderson} and Lovett Lawson and Najla Al-Sonboli and Nasher Al-Aghbari and Isabel Arbide and Sherchand, {Jeevan B} and Nnamdi, {Emenyonu E} and Abraham Aseffa and Yassin, {Mohammed A} and Abdurrahman, {Saddiq T} and Joshua Obasanya and Oladimeji Olanrewaju and Daniel Datiko and Theobald, {Sally J} and Andrew Ramsay and Squire, {S Bertel} and Cuevas, {Luis E}",

year = "2016",

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doi = "10.1186/s40249-016-0117-x",

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pages = "24",

journal = "Infectious Diseases of Poverty",

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T1 - Patients direct costs to undergo TB diagnosis

AU - de Cuevas, Rachel M Anderson

AU - Lawson, Lovett

AU - Al-Sonboli, Najla

AU - Al-Aghbari, Nasher

AU - Arbide, Isabel

AU - Sherchand, Jeevan B

AU - Nnamdi, Emenyonu E

AU - Aseffa, Abraham

AU - Yassin, Mohammed A

AU - Abdurrahman, Saddiq T

AU - Obasanya, Joshua

AU - Olanrewaju, Oladimeji

AU - Datiko, Daniel

AU - Theobald, Sally J

AU - Ramsay, Andrew

AU - Squire, S Bertel

AU - Cuevas, Luis E

PY - 2016/3/24

Y1 - 2016/3/24

N2 - BACKGROUND: A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.METHODS: We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure.RESULTS: The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy.CONCLUSIONS: The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

AB - BACKGROUND: A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.METHODS: We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure.RESULTS: The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy.CONCLUSIONS: The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

KW - Adult

KW - Aged

KW - Cost of Illness

KW - Female

KW - Health Expenditures

KW - Humans

KW - Male

KW - Middle Aged

KW - Nepal

KW - Nigeria

KW - Prospective Studies

KW - Rural Population

KW - Tuberculosis/diagnosis

KW - Yemen

KW - Young Adult

U2 - 10.1186/s40249-016-0117-x

DO - 10.1186/s40249-016-0117-x

M3 - Article

C2 - 27009093

SN - 2049-9957

VL - 5

SP - 24

JO - Infectious Diseases of Poverty

JF - Infectious Diseases of Poverty

ER -

Patients direct costs to undergo TB diagnosis

Abstract

Keywords

UN SDGs

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