A model of the cost-effectiveness of directly observed therapy for treatment of tuberculosis.
A hypothetical cohort of 25,000 TB patients and their contacts were followed for a 10-year period; rates of treatment default, infectiousness following partial treatment, relapse, hospitalization, and development of drug-resistant TB were included. The average cost per case cured was $16,846 with 15% of patients starting DOT, $17,323 with 100% starting DOT, and $20,106 with none starting DOT. The incremental cost per additional case cured was $24,064 when all patients, started treatment on DOT, indicating that outpatient DOT provides a cost-effective method of improving health outcomes for TB patients and their contacts while controlling direct costs.
Palmer
C S
CS
MEDTAP International, Bethesda, MD, USA.
Miller
B
B
Halpern
M T
MT
Geiter
L J
LJ
D000328:Adult; D000553:Ambulatory Care / Q000191:economics*; D015982:Bias; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D019370:Observation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology; D011369:Professional-Patient Relations; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D014376:Tuberculosis / Q000188:drug therapy* / Q000191:economics* / Q000523:psychology; D014481:United States