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1.
Arch Bronconeumol ; 52(12): 583-589, 2016 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27323653

RESUMO

OBJECTIVE: To analyze the direct and indirect costs of diagnosis and management of tuberculosis (TB) and associated factors. PATIENTS AND METHODS: Prospective study of patients diagnosed with TB between September 2014 and September 2015. We calculated direct (hospital stays, visits, diagnostic tests, and treatment) and indirect (sick leave and loss of productivity, contact tracing, and rehabilitation) costs. The following cost-related variables were compared: age, gender, country of origin, hospital stays, diagnostic testing, sensitivity testing, treatment, resistance, directed observed therapy (DOT), and days of sick leave. Proportions were compared using the chi-squared test and significant variables were included in a logistic regression analysis to calculate odds ratio (OR) and corresponding 95% confidence intervals. RESULTS: 319 patients were included with a mean age of 56.72±20.79 years. The average cost was €10,262.62±14,961.66, which increased significantly when associated with hospital admission, polymerase chain reaction, sputum smears and cultures, sensitvity testing, chest computed tomography, pleural biopsy, drug treatment longer than nine months, DOT and sick leave. In the multivariate analysis, hospitalization (OR=96.8; CI 29-472), sensitivity testing (OR=4.34; CI 1.71-12.1), chest CT (OR= 2.25; CI 1.08-4.77), DOT (OR=20.76; CI 4.11-148) and sick leave (OR=26,9; CI 8,51-122) showed an independent association with cost. CONCLUSION: Tuberculosis gives rise to significant health spending. In order to reduce these costs, more control of transmission, and fewer hospital admissions would be required.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Tuberculose/economia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/economia , Antituberculosos/uso terapêutico , Intervalos de Confiança , Testes Diagnósticos de Rotina/economia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores Sexuais , Licença Médica/economia , Licença Médica/estatística & dados numéricos , Espanha/epidemiologia , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Adulto Jovem
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