title: Causes and costs of hospitalization of tuberculosis patients in the United States.
abstract: OBJECTIVE
  To examine the costs, lengths of stay and patient characteristics associated with tuberculosis (TB) hospitalizations.
  
  
  METHODS
  A prospective cohort study of 1493 TB patients followed from diagnosis to completion of therapy at 10 public health programs and area hospitals in the US. The main outcome measures were the following: 1) occurrence, 2) cost, and 3) length of stay of TB-related hospitalizations.
  
  
  RESULTS
  There were 821 TB-related hospitalizations among the study participants; 678 (83%) were initial hospitalizations and 143 (17%) were hospitalizations during the treatment of TB. Patients infected with human immunodeficiency virus (HIV) (OR 1.8, 95% CI 1.2-2.6), and homeless patients (OR, 1.7 95% CI 1.1-2.8) were at increased risk of being hospitalized at diagnosis. Homeless patients (RR 2.5, 95%CI 1.5-4.3), patients who used alcohol excessively (RR 1.9, 95% CI 1.2-3.0), and patients with multidrug-resistant TB (RR 5.7, 95% CI 2.7-11.8) were at increased risk of hospitalization during treatment. The median length of stay varied from 9 to 17 days, and median costs per hospitalization varied from $6441 to $12968 among the sites.
  
  
  CONCLUSIONS
  Important social factors, HIV infection, and local hospitalization practice patterns contribute significantly to the high cost of TB-related hospitalizations. Efforts to address these specific factors are needed to reduce the cost of preventable hospitalizations.
authors.affiliation: Division of Tuberculosis Elimination, National Center for HIV, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. zxt0@cdc.gov
authors.forename: Z
authors.initials: Z
authors.lastname: Taylor
authors.forename: S M
authors.initials: SM
authors.lastname: Marks
authors.forename: N M
authors.initials: NM
authors.lastname: Ríos Burrows
authors.forename: S E
authors.initials: SE
authors.lastname: Weis
authors.forename: R L
authors.initials: RL
authors.lastname: Stricof
authors.forename: B
authors.initials: B
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications; D017048:Health Care Costs; D006703:Ill-Housed Persons; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012924:Social Conditions; D014397:Tuberculosis, Pulmonary / Q000191:economics* / Q000209:etiology* / Q000628:therapy; D014481:United States