将灾难性成本进行比较:主动与主动. 在城市越南发现被动结核病例
Luong V Dinh1, Anja M C Wiemers2, Rachel J Forse2,3
1National Lung Hospital, Ha Noi 10000, Vietnam.
Tropical medicine and infectious disease
|September 27, 2023
概括
结核病 (TB) 的活跃病例发现 (ACF) 显著降低了患者成本和失业. 然而,它并不能完全防止灾难性成本,强调了扩大社会保护的必要性.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病流行病学 传染病流行病学
背景情况:
- 结核病 (TB) 仍然是一个全球卫生挑战,灾难性成本是治疗坚持的主要障碍,也是世卫组织结核病终结战略的目标.
- 活跃病例发现 (ACF) 是一种外展策略,以更早地发现结核病例,从而有可能减轻对患者的社会经济影响.
研究的目的:
- 评估与被动结核病检测相比,发现活跃病例 (ACF) 的社会经济影响.
- 评估结核病患者的费用,失业和结核病患者的灾难性成本.
主要方法:
- 一项前性纵向研究,比较药物敏感性肺结核患者的患者成本.
- 在四个越南城市 (2020年10月 - 2022年3月) 调查了105名通过ACF检测到的个人和107名被动检测到的个人.
- 收集的数据包括治疗前费用,治疗费用,失业和应对策略的使用.
主要成果:
- ACF显著降低了治疗前的费用 (10美元比101美元) 和治疗费用 (888美元比1213美元).
- ACF减少了失业 (15.2%与35.5%) 和应对策略的使用 (28.6%与45.7%).
- 灾难性成本发生率仍然很高 (52.8%),并且在队列之间没有显著差异,间接成本是主要的驱动因素.
结论:
- 虽然ACF减少了与结核病检测和治疗相关的直接和间接成本,但它并没有足够减少灾难性成本的风险.
- 收入损失是结核病治疗期间灾难性成本的最大贡献者.
- 扩大社会保护计划对于解决结核病的财务负担和实现终结结核病战略目标至关重要.
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