Liverpool School of Tropical Medicine, Liverpool, UK.
Int J Tuberc Lung Dis. 2010 Feb;14(2):165-70.
The diagnosis of TB requires multiple visits. Reducing the number of visits for diagnosis could make the process more accessible, with significant savings to the patients.
To describe direct costs incurred by patients consulting TB diagnostic centres.
Adults with cough >3 weeks' duration were interviewed using structured questionnaires in Yemen and Nepal to quantify their expenses.
A total of 456 adults were interviewed. Most patients were accompanied, and 20% were smear-positive. Patients in Nepal were more likely to be male, to live in urban areas and were older (123/206 [60%], 152 [74%] and mean age 41 years) than in Yemen (120/250 [48%], 114 [36%] and mean age 35 years). Although most patients from rural areas stayed with relatives, their overall expenses were higher than for patients from urban areas. Clinic fees represented the highest expenditure in both countries, and rural patients paid more than urban patients in both settings. The expenses for diagnosis were equivalent to 1 week of the national income per capita.
Patients incur considerable costs for diagnosis, and clinic fees represent a substantial component of these costs. Patients requiring investigations for TB should be able to access diagnostic services free of charge.
结核病的诊断需要多次就诊。减少诊断所需的就诊次数可以使诊断过程更加便捷，同时为患者节省大量费用。
描述患者前往结核病诊断中心就诊所产生的直接费用。
在也门和尼泊尔，对咳嗽持续时间超过 3 周的成年人采用结构式问卷进行访谈，以量化他们的支出。
共访谈了 456 名成年人。大多数患者有陪同人员，20%的患者为涂片阳性。与也门相比，尼泊尔的患者更有可能是男性、居住在城市地区且年龄更大（123/206 [60%]、152 [74%]和平均年龄 41 岁），而也门的患者更有可能是女性、居住在农村地区且年龄更小（120/250 [48%]、114 [36%]和平均年龄 35 岁）。尽管大多数农村地区的患者都住在亲戚家，但他们的总支出高于城市地区的患者。在两国，诊所费用都是最高的支出，农村患者在这两种情况下的支出都高于城市患者。诊断费用相当于人均国民收入的一周。
患者在诊断方面产生了相当大的费用，而诊所费用是这些费用的主要组成部分。需要接受结核病检查的患者应能够免费获得诊断服务。
