The cost of tuberculosis: utilization and estimated charges for the diagnosis and treatment of tuberculosis in a public health system.
METHODS
An urban tuberculosis (TB) control program.


OBJECTIVE
The use of medical services was analyzed from diagnosis through completion of treatment for TB patients in a public health system in order to estimate charges and service utilization.


METHODS
The in- and out-patient medical records, including long term care and jail health service records, were retrospectively reviewed for the first 100 patients diagnosed with TB in 1993 at a public hospital. Because the hospital did not have a cost-accounting system, charges were estimated based on a variety of sources.


RESULTS
Complete records were available for 92 patients; one outlier was excluded. The resulting 91 patients represented 11% of newly diagnosed patients in Chicago in 1993. Overall, almost 99% of the charges reflected in-patient (acute and long term care) utilization. Total charges of $3,154,583 represent the charges to complete therapy for only 46 patients, or $68,578 per completed case.


CONCLUSIONS
This study attempts to overcome the limitations of aggregate data sets by looking at individual patients followed longitudinally through a complex public health system. Expensive in-patient care may be partially, but not completely, replaced by directly observed therapy. The findings may be used to predict resource utilization for diagnosis and treatment programs.
Wurtz
R
R
Department of Medicine, Evanston Hospital, Illinois 60201, USA. rwurtz@nwu.edu
White
W D
WD
D000328:Adult; D002641:Chicago; D017281:Cost of Illness; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006779:Hospitals, Public / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D014505:Urban Population