Characteristics and costs of multidrug-resistant tuberculosis in-patient care in the United States, 2005–2007

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Marks, S. M. ; Hirsch-Moverman, Y. ; Salcedo, K. ; Graviss, E. A. ; Oh, P. ; Seaworth, B. ; Flood, J. ; Armstrong, L. ; Armitige, L. ; Mase, S.
• Corporate Authors:
  TB Epidemiologic Studies Consortium
• Description:
  OBJECTIVE
  
  A population-based study of 135 multidrug-resistant tuberculosis (MDR-TB) patients reported to the Centers for Disease Control and Prevention (CDC) during 2005–2007 found 73% were hospitalized. We analyzed factors associated with hospitalization.
  
  METHODS
  
  We assessed statistically significant multivariable associations with US in-patient TB diagnosis, frequency of hospitalization, length of hospital stay, and in-patient direct costs to the health care system.
  
  RESULTS
  
  Of 98 hospitalized patients, 83 (85%) were foreign-born. Blacks, diabetics, or smokers were more likely, and patients with disseminated disease less likely, to receive their TB diagnosis while hospitalized. Patients aged ⩾65 years, those with the acquired immune-deficiency syndrome (AIDS), or with private insurance, were hospitalized more frequently. Excluding deaths, length of stay was greater for patients aged ⩾65 years, those with extensively drug-resistant TB (XDR-TB), those residing in Texas, those with AIDS, those who were unemployed, or those who had TB resistant to all first-line medications vs. others. Average hospitalization cost per XDR-TB patient (US$285 000) was 3.5 times that per MDR-TB patient (US$81 000), in 2010 dollars. Hospitalization episode costs for MDR-TB rank third highest and those for XDR-TB highest among the principal diagnoses.
  
  CONCLUSIONS
  
  Hospitalization was common and remains a critical care component for patients who were older, had comorbidities, or required complex management due to XDR-TB. MDR-TB in-patient costs are among the highest for any disease.
  
  
• Subjects:
  Aged Antitubercular Agents Costs And Cost Analysis Extensively Drug-Resistant Tuberculosis Female Health Care Costs Hospitalization Humans Length Of Stay Logistic Models Male Patient Care

  More +
• Source:
  Int J Tuberc Lung Dis. 20(4):435-441
• Pubmed ID:
  26970150
• Pubmed Central ID:
  PMC4832576
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  20
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5e31cc3fdfe58215f8842a0780cce7580130c44e7120e711b1c21b01e144384f
• Download URL:
  https://stacks.cdc.gov/view/cdc/38961/cdc_38961_DS1.pdf
• File Type:
  [PDF - 341.91 KB ]