We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Costs and outcomes of tuberculosis control in the Russian Federation: retrospective cohort analysis.
- Authors
RA Atun; Y Samyshkin; F Drobniewski; Y Balabanova; IM Fedorin; J Lord; RJ Coker
- Abstract
We analysed costs and outcomes of tuberculosis care for patients in a traditional Russian tuberculosis control system, using 3-year retrospective cohort data. Of 1749 cases at 3 years of follow-up, 65% were cured, 11.3% (198/1749) still had ‘active’ or ‘chronic’ disease, 10.3% had transferred out of the local civilian health care system and 12.7% had died. The mean cost of managing one case over 3 years was US$886: US$1078 for bacteriologically confirmed (BK+) cases and US$718 for bacteriologically unconfirmed (BK−) cases. Approximately 60% of treatment costs were incurred in the first 12 months and 40% incurred in the remaining 2 years. Around 60% of the total cost was accounted for by hospital inpatient care.The cost, treatment and outcome of BK+ and BK− cases differed substantially. The cost of treating BK+ cases was 50% higher than treating BK− cases due to higher hospitalization rates and the additional cost of managing BK+ cases that become ‘chronic’. While BK+ cases accounted for 55% of total health expenditure on tuberculosis, the share of BK− cases was 45% of the total – due to hospitalization and lengthy periods of follow up.The costs of treating tuberculosis in the Russian tuberculosis control system are very high compared with other high-burden countries due to hospitalization policies and lengthy case management periods. Much of this expenditure can be avoided if the WHO-recommended DOTS strategy is implemented. In particular, the proportion of expenditure for BK− cases is surprisingly high and can be avoided as most of these patients do not need hospitalizing or lengthy periods of follow-up.
- Subjects
RUSSIA; MEDICAL care costs; TUBERCULOSIS; HEALTH
- Publication
Health Policy & Planning, 2006, Vol 21, Issue 5, p353
- ISSN
0268-1080
- Publication type
Article
- DOI
10.1093/heapol/czl023