RT Journal Article
SR Electronic
T1 Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01934-2013
DO 10.1183/09031936.00193413
A1 Tadayuki Tanimura
A1 Ernesto Jaramillo
A1 Diana Weil
A1 Mario Raviglione
A1 Knut Lönnroth
YR 2014
UL http://erj.ersjournals.com/content/early/2014/02/20/09031936.00193413.abstract
AB In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%) to income loss. Half of the total cost was incurred before TB treatment. On average, the total cost was equivalent to 58% (range 5–306%) of reported annual individual and 39% (4–148%) of reported household income. Cost as percentage of income was particularly high among poor people and those with multidrug-resistant TB. Commonly reported coping mechanisms included taking a loan and selling household items. The total cost of TB for patients can be catastrophic. Income loss often constitutes the largest financial risk for patients. Apart from ensuring that healthcare services are fairly financed and delivered in a way that minimises direct and indirect costs, there is a need to ensure that TB patients and affected families receive appropriate income replacement and other social protection interventions. Costs and income loss put people with TB at financial risk, requiring mitigation with social protection interventions http://ow.ly/sqgRU