SETTING: Division of respiratory medicine in a specialised infectious disease hospital in Rome, Italy. OBJECTIVE: Retrospective evaluation of tuberculosis (TB) care associated costs in an integrated in- and outpatient management programme. DESIGN: Review of the medical records of 92 human immunodeficiency virus negative TB cases admitted between September 2000 and May 2003. RESULTS: Length of in-hospital stay (45 +/- 35 days) was the major cost determinant, as hospitalisation accounted for almost 80% of the total costs of the case, with fixed bed-per-day charges amounting to 76% of hospital costs. Factors associated with higher costs were chest X-ray SUMMARY score, fever, sputum bacterial load and multidrug resistance (P < 0.05). Cure/treatment completion was achieved in 82% of patients entering the out-patient programme (63% of all cases). Homelessness, age and comorbidities were associated with unfavourable outcomes. CONCLUSIONS: A closely followed hospital-centred protocol carried out in a high-resource setting may produce acceptable cure/completion treatment rates. As a too high fraction of resources invested in TB control goes toward hospital costs, out-patient treatment strategies should be implemented.

Bocchino, M., Greco, S., Rosati, Y., Mattioli, G., Marruchella, A., De Mori, P., et al. (2006). Cost determinants of tuberculosis management in a low-prevalence country. In International Journal of Tuberculosis and Lung Disease (pp.146-152). PARIS : INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D).

Cost determinants of tuberculosis management in a low-prevalence country

SALTINI, CESARE
2006-01-01

Abstract

SETTING: Division of respiratory medicine in a specialised infectious disease hospital in Rome, Italy. OBJECTIVE: Retrospective evaluation of tuberculosis (TB) care associated costs in an integrated in- and outpatient management programme. DESIGN: Review of the medical records of 92 human immunodeficiency virus negative TB cases admitted between September 2000 and May 2003. RESULTS: Length of in-hospital stay (45 +/- 35 days) was the major cost determinant, as hospitalisation accounted for almost 80% of the total costs of the case, with fixed bed-per-day charges amounting to 76% of hospital costs. Factors associated with higher costs were chest X-ray SUMMARY score, fever, sputum bacterial load and multidrug resistance (P < 0.05). Cure/treatment completion was achieved in 82% of patients entering the out-patient programme (63% of all cases). Homelessness, age and comorbidities were associated with unfavourable outcomes. CONCLUSIONS: A closely followed hospital-centred protocol carried out in a high-resource setting may produce acceptable cure/completion treatment rates. As a too high fraction of resources invested in TB control goes toward hospital costs, out-patient treatment strategies should be implemented.
35th World Conference on Lung Health of the International-Union-Against-Tuberculosis-and-Lung-Disease
Paris, FRANCE
OCT 28-NOV 01, 2004
Int Union Against Tuberculosis & Lung Dis
Rilevanza internazionale
2006
Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO
English
Case outcome; Costs; Hospital care; Tuberculosis
tuberculostatic agent; adult; demography; drug cost; drug tolerance; female; fever; health care cost; hospital cost; hospitalization; human; Human immunodeficiency virus; major clinical study; male; medical record; multidrug resistance; priority journal; prognosis; review; sputum analysis; thorax radiography; tuberculosis; Adult; Aged; Antitubercular Agents; Female; Health Care Costs; Hospitalization; Humans; Italy; Male; Middle Aged; Outcome Assessment (Health Care); Prevalence; Retrospective Studies; Tuberculosis
Intervento a convegno
Bocchino, M., Greco, S., Rosati, Y., Mattioli, G., Marruchella, A., De Mori, P., et al. (2006). Cost determinants of tuberculosis management in a low-prevalence country. In International Journal of Tuberculosis and Lung Disease (pp.146-152). PARIS : INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D).
Bocchino, M; Greco, S; Rosati, Y; Mattioli, G; Marruchella, A; De Mori, P; Bibbolino, C; Girardi, E; Squarcione, S; Saltini, C
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/56978
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact