Is Tuberculosis Treatment Truly Free? A Study to Identify Key Factors Contributing to the Catastrophic Cost of TB Care in Pakistan

作     者：Aamer Ikram Amna Ali Sana Habib Abbasi Nosheen Ashraf Sidra Wali Mohammad Salman Mumtaz A. Khan Naveed Syed Jamil A. Ansari Aamer Ikram;Amna Ali;Sana Habib Abbasi;Nosheen Ashraf;Sidra Wali;Mohammad Salman;Mumtaz A. Khan;Naveed Syed;Jamil A. Ansari

作者机构：National Institute of Health Islamabad Pakistan Public Health England London UK 

出 版 物：《Journal of Tuberculosis Research》 (结核病研究（英文）)

年 卷 期：2020年第8卷第4期

页      面：181-198页

学科分类：07[理学] 0701[理学-数学] 070101[理学-基础数学] 

主　　题：Tuberculosis Financial Deprivation Catastrophic Cost 

摘      要：Background:The interplay between financial deprivation and tuberculosis (TB) is considered one of the vital socio-economic determinants of disease. This is the first study of its kind to be carried in Pakistan, which aims to identify leading factors contributing towards catastrophic costs of TB diagnosis and management in order to help policy makers. Methodology:From four tertiary care hospitals (TCH) in Islamabad and Rawalpindi, 400 TB patients were interviewed through a cross-sectional survey. The patient’s pre and post-TB income and direct and indirect costs for treatment were analysed following WHO recommendations. Multivariable logistic regression model was used to identify the determinants of catastrophic total cost. Results:For TB management expenditures, the median (interquartile range) of total costs by households was Rs.58,175 Rs(32,050 - 97,500). At 20% threshold, 67% of TB patient’s households were affected by catastrophic