Volume 26, Number 5—May 2020
Dispatch
Pretreatment Out-of-Pocket Expenses for Presumptive Multidrug-Resistant Tuberculosis Patients, India, 2016–2017
, Kalpita Shringarpure, Bhaskaran Unnikrishnan, Vineet Kumar Chadha, Vishak Acharya, Abirami Nair, Karuna D. Sagili, and Suresh Shastri
Table 2
Median disaggregated costs incurred by 40 patients (households) from the stage of presumptive MDR TB to pre-MDR TB treatment evaluation, India, August 2016–April 2017*
| Cost category | Median (IQR), USD |
|---|---|
| Total income |
608.00 (228.00–912.00) |
| Total direct medical costs† |
37.44 (7.10–198.24) |
| Total diagnosis, n = 38 |
01.58 (0.30–2.40) |
| Total investigation, n = 36 |
17.70 (3.19–60.27) |
| Total treatment, n = 26 |
15.07 (11.30–47.08) |
| Total admission, n = 15 |
45.20 (30.13–75.34) |
| Total direct nonmedical costs‡ |
51.20 (28.00–85.36) |
| Total food, n = 38 |
35.41 (18.08–64.97) |
| Total travel, n = 39 |
12.84 (5.73–12.84) |
| Total accommodations, n = 1 |
36.16 (36.16–36.16) |
| Additional nutrition, n = 38 |
01.51 (0.75–3.77) |
| Total direct costs§ |
105.12 (48.75–306) |
| Total indirect costs, n = 18¶ |
51.20 (1.60–306.00) |
| Total expenditures# |
171.31 (72.00–432.00) |
| Total coping costs | 640.00 (324.00–1,360) |
*Because all patients did not incur all categories of costs, n differs for different categories. Median (IQR) is calculated only for those who incurred a given cost. IQR, interquartile range; MDR TB, multidrug-resistant TB; TB, tuberculosis: USD, US dollars.
†Direct medical costs = sum of diagnosis investigation (general investigation and disease-specific investigations), complete blood count, erythrocyte sedimentation rate, liver function testing, renal function testing, spirometry, computed tomography, magnetic resonance imaging. Disease specific cost = sputum-smear microscopy, culture, drug-susceptibility testing, radiography, drugs, and hospitalization.
‡Direct nonmedical costs = sum of food, accommodation, travel by both patient and attendant.
§Direct costs = sum of total direct medical costs and total direct nonmedical costs.
¶Indirect costs = loss of wages for patient and attendant during the visit.
#Total expenditure = sum of total direct and total indirect costs.