Costs of patients hospitalized for multidrug-resistant tuberculosis.
METHODS
From 1993 through 1998, 1846 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in the United States. Costs associated with MDR-TB are likely to be much higher than for drug-susceptible tuberculosis due to longer hospitalization, longer treatment with more expensive and toxic medications, greater productivity losses, and higher mortality.


OBJECTIVE
To measure the societal costs of patients hospitalized for MDR-TB.


METHODS
We detailed in-patient costs for 13 multidrug-resistant patients enrolled in a national study. We estimated costs for physician care, out-patient treatment, and productivity losses for survivors and for deceased patients.


RESULTS
In-patient costs averaged US$25,853 per person and $1036 per person-day of hospitalization. Outpatient costs per person ranged from $5744 to $41,821 (average $19028, or $44 a day). Direct medical costs averaged $44,881; indirect costs for those who survived averaged $32,964, and indirect costs for those who died averaged $686,381 per person. Total costs per person ranged from $28,217 to $181492 (average $89,594) for those who survived, and from $509490 to $1278066 (average $717555) for those who died.


CONCLUSIONS
The societal costs of MDR-TB varied, mostly because of length of therapy (including in-patient), and deaths during treatment.
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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D000328:Adult; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D049671:History, 18th Century; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018088:Tuberculosis, Multidrug-Resistant / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology