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The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China

PURPOSE: We aimed to assess the household financial burden due to multidrug-resistant tuberculosis (MDR-TB) treatment and its predictors, examine its association with patient mobility, and test their impact on patient loss to follow-up (LTFU). METHODS: A cross-sectional study combining follow-up dat...

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Autores principales: Wang, Yun, Huang, Zhongfeng, Chen, Huijuan, Yuan, Ye, McNeil, Edward B, Lu, Xiaolong, Zhang, Aihua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10200133/
https://www.ncbi.nlm.nih.gov/pubmed/37220483
http://dx.doi.org/10.2147/RMHP.S400667
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author Wang, Yun
Huang, Zhongfeng
Chen, Huijuan
Yuan, Ye
McNeil, Edward B
Lu, Xiaolong
Zhang, Aihua
author_facet Wang, Yun
Huang, Zhongfeng
Chen, Huijuan
Yuan, Ye
McNeil, Edward B
Lu, Xiaolong
Zhang, Aihua
author_sort Wang, Yun
collection PubMed
description PURPOSE: We aimed to assess the household financial burden due to multidrug-resistant tuberculosis (MDR-TB) treatment and its predictors, examine its association with patient mobility, and test their impact on patient loss to follow-up (LTFU). METHODS: A cross-sectional study combining follow-up data collection was conducted at the largest designated MDR-TB hospital in Guizhou. Data were collected from medical records and questionnaires. Household financial burden was measured by the incidence of 2 indicators: catastrophic total costs (CTC) and catastrophic health expenditure (CHE). Mobility was classified as mover or non-mover after the patient’s address was verified twice. A multivariate logistic regression model was used to identify associations between variables. Model I and Model II were separated by CHE and CTC. RESULTS: Out of 180 households, the incidence of CHE and CTC was 51.7% and 80.6%, respectively. Families with low income and patients who were primary income earners were significantly associated with catastrophic costs. 42.8% of patients were movers. Patients from households with CHE (OR(adj)=2.2, 95% CI: 1.1–4.1) or with CTC (OR(adj)=2.6, 95% CI: 1.1–6.3) were more likely to move. Finding a job against financial difficulty (58.4%) was the top reason for movers. 20.0% of patients experienced LTFU. Patients from households with catastrophic payments (CHE: OR(adj)=4.1, 95% CI 1.6–10.5 in Model I; CTC: OR(adj)=4.8, 95% CI 1.0–22.9 in Model II), patients who were movers (OR(adj)=6.1, 95% CI 2.5–14.8 in Model I; OR(adj)=7.4, 95% CI 3.0–18.7 in Model II) and primary income earners (OR(adj)=2.5, 95% CI: 1.0–5.9 in Model I; OR(adj)=2.7, 95% CI 1.1–6.6 in Model II) had an increased risk of LTFU. CONCLUSION: There is a significant association between household financial burden due to MDR-TB treatment and patient mobility in Guizhou. They impact patients’ treatment adherence and cause LTFU. Being a primary breadwinner increases the risk for catastrophic household payments and LTFU.
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spelling pubmed-102001332023-05-22 The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China Wang, Yun Huang, Zhongfeng Chen, Huijuan Yuan, Ye McNeil, Edward B Lu, Xiaolong Zhang, Aihua Risk Manag Healthc Policy Original Research PURPOSE: We aimed to assess the household financial burden due to multidrug-resistant tuberculosis (MDR-TB) treatment and its predictors, examine its association with patient mobility, and test their impact on patient loss to follow-up (LTFU). METHODS: A cross-sectional study combining follow-up data collection was conducted at the largest designated MDR-TB hospital in Guizhou. Data were collected from medical records and questionnaires. Household financial burden was measured by the incidence of 2 indicators: catastrophic total costs (CTC) and catastrophic health expenditure (CHE). Mobility was classified as mover or non-mover after the patient’s address was verified twice. A multivariate logistic regression model was used to identify associations between variables. Model I and Model II were separated by CHE and CTC. RESULTS: Out of 180 households, the incidence of CHE and CTC was 51.7% and 80.6%, respectively. Families with low income and patients who were primary income earners were significantly associated with catastrophic costs. 42.8% of patients were movers. Patients from households with CHE (OR(adj)=2.2, 95% CI: 1.1–4.1) or with CTC (OR(adj)=2.6, 95% CI: 1.1–6.3) were more likely to move. Finding a job against financial difficulty (58.4%) was the top reason for movers. 20.0% of patients experienced LTFU. Patients from households with catastrophic payments (CHE: OR(adj)=4.1, 95% CI 1.6–10.5 in Model I; CTC: OR(adj)=4.8, 95% CI 1.0–22.9 in Model II), patients who were movers (OR(adj)=6.1, 95% CI 2.5–14.8 in Model I; OR(adj)=7.4, 95% CI 3.0–18.7 in Model II) and primary income earners (OR(adj)=2.5, 95% CI: 1.0–5.9 in Model I; OR(adj)=2.7, 95% CI 1.1–6.6 in Model II) had an increased risk of LTFU. CONCLUSION: There is a significant association between household financial burden due to MDR-TB treatment and patient mobility in Guizhou. They impact patients’ treatment adherence and cause LTFU. Being a primary breadwinner increases the risk for catastrophic household payments and LTFU. Dove 2023-05-17 /pmc/articles/PMC10200133/ /pubmed/37220483 http://dx.doi.org/10.2147/RMHP.S400667 Text en © 2023 Wang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wang, Yun
Huang, Zhongfeng
Chen, Huijuan
Yuan, Ye
McNeil, Edward B
Lu, Xiaolong
Zhang, Aihua
The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title_full The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title_fullStr The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title_full_unstemmed The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title_short The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China
title_sort association between household financial burden and patient mobility and their impact on loss to follow-up among multidrug-resistant tuberculosis patients in guizhou, china
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10200133/
https://www.ncbi.nlm.nih.gov/pubmed/37220483
http://dx.doi.org/10.2147/RMHP.S400667
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