Catastrophic costs in tuberculosis patients in Brazil: a study in five capitals
Costos catastróficos en pacientes con tuberculosis en Brasil: un estudio en cinco capitales
Custos catastróficos em pacientes com tuberculose no Brasil: estudo em cinco capitais
Leticia Molino Guidoni; Leticya dos Santos Almeida Negri; Geisa Fregona Carlesso; Eliana Zandonade; Ethel Leonor Noia Maciel
Abstract
Objective: to assess the home economics impact of illness from Tuberculosis in Brazil.
Method: multicenter cross-sectional research from 2016 to 2018, in five capitals of Brazil, in patients diagnosed with tuberculosis. The total costs were the sum of the direct and indirect costs incurred before and during diagnosis and treatment. Logistic regression was used to study determinants of catastrophic costs. Poverty was measured as daily household income per capita < U$ 5.5.
Results: 361 patients were enrolled in the study. The extrapolation cost was R$ 3,664.47 (SD: R$ 2,667.67) and the total extrapolation cost was R$ 22,291.82 (SD: R$ 16,259.50). Overall, 29% of study participants were characterized as poor before tuberculosis, and 39% afterwards. On average, income declined by 11% among participants and 41% had catastrophic costs. The statistically significant determinants of experiencing catastrophic costs were: participant being the head of the family; living in poverty before tuberculosis; unemployment and interruption of work during treatment (p <0.05).
Conclusion and implications for practice: although treatment is financed by the government, tuberculosis continues to cause catastrophic costs and decreased of income for many families in Brazil.
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Resumo
Objetivo: avaliar o impacto econômico domiciliar do adoecimento pela tuberculose no Brasil.
Método: pesquisa transversal multicêntrica de 2016 a 2018, em cinco capitais do Brasil, em pacientes diagnosticados com tuberculose. Os custos totais foram a soma dos custos diretos e indiretos incorridos antes e durante o diagnóstico e tratamento. A regressão logística foi utilizada para estudar determinantes de custos catastróficos. A pobreza foi medida como renda familiar per capita diária < U$ 5,5.
Resultados: trezentos e sessenta e um pacientes foram inscritos no estudo. O custo extrapolação foi de R$3.664,47 (DP: R$ 2.667,67) e o custo total de extrapolação foi de R$22.291,82 (DP: R$ 16.259,50). No geral, 29% dos participantes do estudo foram caracterizados como pobres antes da tuberculose, e 39% depois. Em média, a renda diminuiu em 11% dos participantes e 41% tiveram custos catastróficos. Os determinantes estatisticamente significativos de experimentar custos catastróficos foram: participante ser o chefe da família, vivendo na pobreza antes da tuberculose, desemprego e interrupção do trabalho durante o tratamento (p < 0,05).
Conclusão e implicações para a prática: embora o tratamento seja financiado pelo governo, a tuberculose continua resultando em custos catastróficos e diminuição da renda para muitas famílias no Brasil.
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Referências
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Submetido em:
26/01/2021
Aceito em:
02/06/2021
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