Bay Vahid, Tabarsi Payam, Rezapour Aziz, Marzban Sima, Zarei Ehsan
Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Osong Public Health Res Perspect. 2017 Oct;8(5):351-357. doi: 10.24171/j.phrp.2017.8.5.09. Epub 2017 Oct 31.
This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran.
In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district's health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider's perspective using an activity-based costing (ABC) method.
The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%).
Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.
本研究旨在估算伊朗戈勒斯坦省阿扎德沙赫尔地区涂片阳性药物敏感型肺结核患者的治疗费用。
在这项回顾性研究中，纳入了2013年4月至2015年12月期间在该地区卫生网络登记并成功完成治疗的所有新涂片阳性肺结核患者（45例）。从提供者的角度，采用作业成本法估算治疗费用。
治疗一名新涂片阳性肺结核患者的费用为1409.00美元（伊朗里亚尔，39438260），可分为直接成本和间接成本（分别为1226.00美元[87%]和183.00美元[13%]）。最高成本（58.1%）与肺结核患者的护理和管理相关（包括46.1%的人力资源成本和12%的直接观察治疗短程实施），其次分别与住院治疗（12.1%）、支持性活动中心（11.4%）、交通（6.5%）、药品（5.3%）以及实验室检查和放射检查（3.2%）相关。
开展针对特定疾病的成本研究有助于医疗系统管理者正确认识该疾病造成的财务负担。这随后可用于确定优先事项、规划、运营预算编制、项目和干预措施的经济评估，最终用于疾病管理。
