Economic Burden of Diabetic Tuberculosis Patients

Abstract

Aim: To assess the impact of diabetes mellitus (DM) on the cost of the tuberculosis (TB) treatment. Study Design: Prevalence based cohort Place and Duration of Study: Penang General Hospital, Hospital USM, and– Univesiti Malaya Medical Center; 2005 – 2008. Methods: Study patients were placed in the TB only, DM only, or DM-TB groups,with each group including 200 patients. Information related to demographics, chronic disease comorbidity, duration of hypertension (HTN) and DM, and economic variables were obtained from the patients’ medical files both at the beginning and end of the study period. The economic burden of DM-TB patients was assessed from hospitalization periods, frequency of clinic visits, and diagnostic requests. Results: Durations of DM and HTN were 9.2 and 5.6 years, respectively, for the DMonly group compared to 5.3 and 1.1 years, respectively, for DM-TB subjects. For both diabetic groups, diabetes preceded HTN, with onset of HTN occurring approximately 4 years after patients were diagnosed diabetic. Approximately 86% of DM only subjects suffered additional comorbidity, and 44.5% had three or more coexisting chronic diseases compared to 56% and 11.4%, respectively, in the DM-TB group. The hospitalization period was 10.2 days for the DM-TB group compared to 7 and 4 days for the TB only and DM only groups, respectively; however, 43% of TB only subjects needed surgical intervention compared to 17% in the DM-TB group. The total cost wasRM4530 (US$1234.3) for the DM-TB group compared to RM3082.8 (US$840) and RM6945.26 (US$1892.40) for theTB only and DM only groups, respectively. Conclusions: DM antedated HTN in our patients. Durations of both DM and HTNwere longer for the DM only group. The number of diagnosed chronic diseases and overall treatment cost was higher in the DM-TB group compared to TB only group, but lower compared to the DM only group. The TB only group required the most surgical intervention.