Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
Where will it end? Pathways to care and catastrophic costs following negative TB evaluation in Uganda.
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DOI：
10.1371/journal.pone.0253927
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Moore DAJ
中科院分区：
文献类型：
--
作者：
Samuels THA;Shete PB;Ojok C;Nalugwa T;Farr K;Turyahabwe S;Katamba A;Cattamanchi A;Moore DAJ
结核病 (TB) 患者产生的灾难性费用受到了相当多的关注，但人们对结核病评估阴性后的费用和护理途径知之甚少。我们对乌干达农村和城郊四个社区卫生中心的 70 名结核病评估呈阴性的患者进行了一项横断面研究。评估后 9 个月，使用结核病登记处的联系信息对患者进行追踪。我们收集了有关医疗就诊的信息，并实施了经过当地验证的成本调查问卷，以评估其症状评估后的财务影响。在 70 名参与者中，有 57 名 (81%) 被追踪，53 名完成了调查。 31/53 (58%) 的受访者在评估后返回医疗机构，平均每次就诊 2 次（四分位距 [IQR] 1-3）。 11.3% (95% CI 4.3–23.0%) 的受访患者和 16.1% (95% CI 5.5–33.7%) 返回医疗机构的患者产生了灾难性费用（即支出超过家庭年收入的 20%）。与失业相关的间接成本占参与者总成本的 80% (IQR 32–100%)。在结核病评估阴性后经历经济灾难的有结核病症状的患者可能比因结核病而遭受费用的患者代表更多的绝对人数。它们可能无法被非结核病灾难性卫生支出的现有定义所涵盖。
Catastrophic costs incurred by tuberculosis (TB) patients have received considerable attention, however little is known about costs and pathways to care after a negative TB evaluation. We conducted a cross-sectional study of 70 patients with a negative TB evaluation at four community health centres in rural and peri-urban Uganda. Patients were traced 9 months post-evaluation using contact information from TB registers. We collected information on healthcare visits and implemented locally-validated costing questionnaires to assess the financial impact of their symptoms post-evaluation. Of 70 participants, 57 (81%) were traced and 53 completed the survey. 31/53 (58%) surveyed participants returned to healthcare facilities post-evaluation, making a median of 2 visits each (interquartile range [IQR] 1–3). 11.3% (95%CI 4.3–23.0%) of surveyed patients and 16.1% (95%CI 5.5–33.7%) of those returning to healthcare facilities incurred catastrophic costs (i.e., spent >20% annual household income). Indirect costs related to lost work represented 80% (IQR 32–100%) of total participant costs. Patients with TB symptoms who experience financial catastrophe after negative TB evaluation may represent a larger absolute number of patients than those suffering from costs due to TB. They may not be captured by existing definitions of non-TB catastrophic health expenditure.
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影响因子：
3.7
作者：
Kapoor SK;Raman AV;Sachdeva KS;Satyanarayana S
通讯作者：
Satyanarayana S
DOI：
10.1183/09031936.00193413
发表时间：
2014-06
期刊：
The European respiratory journal
影响因子：
--
作者：
Tanimura T;Jaramillo E;Weil D;Raviglione M;Lönnroth K
通讯作者：
Lönnroth K
DOI：
10.2471/blt.06.033167
发表时间：
2007-08-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Kemp, Julia R;Mann, Gillian;Squire, Stephen Bertel
通讯作者：
Squire, Stephen Bertel
影响因子：
3.3
作者：
Pedrazzoli, Debora;Siroka, Andrew;Borghi, Josephine
通讯作者：
Borghi, Josephine
影响因子：
15.8
作者：
Loennroth, Knut;Glaziou, Philippe;Raviglione, Mario
通讯作者：
Raviglione, Mario