دورية أكاديمية
أعرض في EDS

Is convenience really king? Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam: a longitudinal patient cost study.

التفاصيل البيبلوغرافية
العنوان: Is convenience really king? Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam: a longitudinal patient cost study.
المؤلفون: Nguyen HB; National Lung Hospital, Ha Noi, Viet Nam., Vo LNQ; Friends for International TB Relief, Ha Noi, Viet Nam. luan.vo@tbhelp.org.; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden. luan.vo@tbhelp.org., Forse RJ; Friends for International TB Relief, Ha Noi, Viet Nam.; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden., Wiemers AMC; Friends for International TB Relief, Ha Noi, Viet Nam., Huynh HB; Friends for International TB Relief, Ha Noi, Viet Nam., Dong TTT; Friends for International TB Relief, Ha Noi, Viet Nam., Phan YTH; Friends for International TB Relief, Ha Noi, Viet Nam., Creswell J; Stop TB Partnership, Geneva, Switzerland., Dang TMH; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam., Nguyen LH; Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam., Shedrawy J; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden., Lönnroth K; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden., Nguyen TD; National Lung Hospital, Ha Noi, Viet Nam., Dinh LV; National Lung Hospital, Ha Noi, Viet Nam., Annerstedt KS; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden., Codlin AJ; Friends for International TB Relief, Ha Noi, Viet Nam.; Department of Global Public Health, WHO Collaboration Centre On Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden.
المصدر: Infectious diseases of poverty [Infect Dis Poverty] 2024 Mar 25; Vol. 13 (1), pp. 27. Date of Electronic Publication: 2024 Mar 25.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101606645 Publication Model: Electronic Cited Medium: Internet ISSN: 2049-9957 (Electronic) Linking ISSN: 20499957 NLM ISO Abbreviation: Infect Dis Poverty Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, 2012-
مواضيع طبية MeSH: Health Care Sector* , Tuberculosis*/drug therapy, Humans ; Vietnam/epidemiology ; Health Care Costs ; Income
مستخلص: Background: In Viet Nam, tuberculosis (TB) represents a devastating life-event with an exorbitant price tag, partly due to lost income from daily directly observed therapy in public sector care. Thus, persons with TB may seek care in the private sector for its flexibility, convenience, and privacy. Our study aimed to measure income changes, costs and catastrophic cost incurrence among TB-affected households in the public and private sector.
Methods: Between October 2020 and March 2022, we conducted 110 longitudinal patient cost interviews, among 50 patients privately treated for TB and 60 TB patients treated by the National TB Program (NTP) in Ha Noi, Hai Phong and Ho Chi Minh City, Viet Nam. Using a local adaptation of the WHO TB patient cost survey tool, participants were interviewed during the intensive phase, continuation phase and post-treatment. We compared income levels, direct and indirect treatment costs, catastrophic costs using Wilcoxon rank-sum and chi-squared tests and associated risk factors between the two cohorts using multivariate regression.
Results: The pre-treatment median monthly household income was significantly higher in the private sector versus NTP cohort (USD 868 vs USD 578; P = 0.010). However, private sector treatment was also significantly costlier (USD 2075 vs USD 1313; P = 0.005), driven by direct medical costs which were 4.6 times higher than costs reported by NTP participants (USD 754 vs USD 164; P < 0.001). This resulted in no significant difference in catastrophic costs between the two cohorts (Private: 55% vs NTP: 52%; P = 0.675). Factors associated with catastrophic cost included being a single-person household [adjusted odds ratio (aOR = 13.71; 95% confidence interval (CI): 1.36-138.14; P = 0.026], unemployment during treatment (aOR = 10.86; 95% CI: 2.64-44.60; P < 0.001) and experiencing TB-related stigma (aOR = 37.90; 95% CI: 1.72-831.73; P = 0.021).
Conclusions: Persons with TB in Viet Nam face similarly high risk of catastrophic costs whether treated in the public or private sector. Patient costs could be reduced through expanded insurance reimbursement to minimize direct medical costs in the private sector, use of remote monitoring and multi-week/month dosing strategies to avert economic costs in the public sector and greater access to social protection mechanism in general.
(© 2024. The Author(s).)
References: Int J Tuberc Lung Dis. 2018 Sep 1;22(9):983-990. (PMID: 30092862)
JAMA Netw Open. 2020 Feb 5;3(2):e1920973. (PMID: 32049293)
Health Policy. 2001 Oct;58(1):69-81. (PMID: 11518602)
Trop Med Infect Dis. 2020 Sep 14;5(3):. (PMID: 32937757)
Respir Med. 2006 Nov;100(11):1862-70. (PMID: 16949809)
Healthcare (Basel). 2022 Jul 12;10(7):. (PMID: 35885812)
BMC Infect Dis. 2016 Oct 4;16(1):537. (PMID: 27716104)
BMC Public Health. 2016 Oct 28;16(1):1130. (PMID: 27793145)
Int J Tuberc Lung Dis. 2020 Oct 1;24(10):1112-1115. (PMID: 33126949)
Health Policy. 1998 Aug;45(2):81-97. (PMID: 10186226)
Eur Respir J. 2016 Nov;48(5):1396-1410. (PMID: 27660507)
BMC Public Health. 2022 Mar 29;22(1):600. (PMID: 35351063)
Int J Health Plann Manage. 2023 Nov;38(6):1613-1628. (PMID: 37485548)
Trop Med Infect Dis. 2023 Aug 23;8(9):. (PMID: 37755885)
Nature. 2013 Oct 10;502(7470):S2-3. (PMID: 24108078)
Lung India. 2019 Mar-Apr;36(2):108-111. (PMID: 30829243)
PLoS Med. 2015 Jun 23;12(6):e1001842. (PMID: 26103555)
Int J Tuberc Lung Dis. 2015 Sep;19(9):1057-64. (PMID: 26260824)
Lancet Glob Health. 2021 Oct;9(10):e1372-e1379. (PMID: 34487685)
Am J Public Health. 2020 Nov;110(11):1696-1703. (PMID: 32941064)
Public Health Action. 2019 Jun 21;9(2):50-52. (PMID: 31417852)
Lancet Public Health. 2021 May;6(5):e272-e282. (PMID: 33765453)
Soc Sci Med. 2001 Mar;52(6):935-48. (PMID: 11234866)
Psychol Health Med. 2006 Aug;11(3):353-63. (PMID: 17130071)
Int J Tuberc Lung Dis. 2019 Nov 1;23(11):1129-1130. (PMID: 31718747)
J Epidemiol Community Health. 2022 Mar;76(3):310-316. (PMID: 34535539)
Infect Dis Poverty. 2018 Jan 12;7(1):3. (PMID: 29325589)
PLOS Digit Health. 2023 Aug 15;2(8):e0000322. (PMID: 37582066)
Health Policy Plan. 2001 Mar;16(1):47-54. (PMID: 11238430)
Int J Infect Dis. 2017 Dec;65:85-89. (PMID: 29030137)
Int J Tuberc Lung Dis. 2003 Feb;7(2):165-71. (PMID: 12588018)
PLoS One. 2010 Nov 17;5(11):e14014. (PMID: 21103344)
PLoS One. 2019 Jul 22;14(7):e0219891. (PMID: 31329610)
Eur Respir J. 2014 Jun;43(6):1763-75. (PMID: 24525439)
BMC Health Serv Res. 2021 Oct 5;21(1):1051. (PMID: 34610841)
Lancet Reg Health West Pac. 2023 Apr 20;36:100770. (PMID: 37547037)
Clin Med (Lond). 2016 Dec;16(Suppl 6):s79-s91. (PMID: 27956446)
Open Forum Infect Dis. 2018 Apr 26;5(4):ofy046. (PMID: 29732378)
BMC Infect Dis. 2020 Feb 12;20(1):134. (PMID: 32050913)
Int J Tuberc Lung Dis. 2019 Jun 1;23(6):756-763. (PMID: 31315710)
PLoS One. 2016 Feb 05;11(2):e0147744. (PMID: 26849656)
J Infect Dis. 2017 Nov 6;216(suppl_7):S686-S695. (PMID: 29117351)
Public Health Rep. 2010 Jul-Aug;125 Suppl 4:34-42. (PMID: 20626191)
BMC Res Notes. 2015 Oct 23;8:600. (PMID: 26499482)
PLoS Med. 2021 Jul 14;18(7):e1003717. (PMID: 34260579)
Health Policy Open. 2020 Aug 28;1:100011. (PMID: 37383313)
Nurs Stand. 2014 Aug 19;28(50):66. (PMID: 25116570)
Lancet Infect Dis. 2018 Dec;18(12):1329-1349. (PMID: 30507459)
Am J Manag Care. 2015 Jan 01;21(1):e35-42. (PMID: 25880266)
BMC Infect Dis. 2015 May 08;15:210. (PMID: 25948059)
Infect Dis Poverty. 2021 Jul 5;10(1):95. (PMID: 34225790)
PLoS One. 2015 Apr 24;10(4):e0123286. (PMID: 25909330)
Glob Public Health. 2024 Jan;19(1):2311682. (PMID: 38325424)
Bull World Health Organ. 2017 Apr 01;95(4):270-280. (PMID: 28479622)
Int J Health Plann Manage. 2021 Mar;36(2):316-333. (PMID: 33022102)
Health Serv Insights. 2021 Jan 21;14:1178632920988843. (PMID: 33597809)
BMC Public Health. 2020 Jun 15;20(1):934. (PMID: 32539700)
Lancet Glob Health. 2017 Nov;5(11):e1123-e1132. (PMID: 29025634)
J Clin Tuberc Other Mycobact Dis. 2021 Jun 25;24:100248. (PMID: 34189276)
معلومات مُعتمدة: STBP/TRREACH/GSA/W7-7001 Stop TB Partnership
فهرسة مساهمة: Keywords: Catastrophic cost; Comparative analysis; Patient cost; Private sector; Tuberculosis; Viet Nam
تواريخ الأحداث: Date Created: 20240326 Date Completed: 20240327 Latest Revision: 20240328
رمز التحديث: 20240329
مُعرف محوري في PubMed: PMC10962209
DOI: 10.1186/s40249-024-01196-2
PMID: 38528604
قاعدة البيانات: MEDLINE
الوصف
تدمد:2049-9957
DOI:10.1186/s40249-024-01196-2