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Volume 26, Number 5—May 2020
Dispatch

Pretreatment Out-of-Pocket Expenses for Presumptive Multidrug-Resistant Tuberculosis Patients, India, 2016–2017

Priya RathiComments to Author , Kalpita Shringarpure, Bhaskaran Unnikrishnan, Vineet Kumar Chadha, Vishak Acharya, Abirami Nair, Karuna D. Sagili, and Suresh Shastri
Author affiliations: Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India (P. Rathi, B. Unnikrishnan, V. Acharya, A. Nair); Medical College Baroda, Baroda, India (K. Shringarpure); Central Leprosy Teaching and Research Institute, Tamil Nadu, India (V.K. Chadha); National Tuberculosis Institute, Epidemiology and Research, Division Bengaluru, India (V.K. Chadha); International Union against Tuberculosis and Lung Disease, South East Asia Office, New Delhi, India (K.D. Sagili); Lady Willington State TB Centre, Bengaluru (S. Shastri)

Main Article

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.

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Page created: April 16, 2020
Page updated: April 16, 2020
Page reviewed: April 16, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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