Cost determinants of tuberculosis management in a low-prevalence country

Int J Tuberc Lung Dis. 2006 Feb;10(2):146-52.


Setting: Division of respiratory medicine in a specialised infectious disease hospital in Rome, Italy.

Objective: Retrospective evaluation of tuberculosis (TB) care associated costs in an integrated in- and out-patient management programme.

Design: Review of the medical records of 92 human immunodeficiency virus negative TB cases admitted between September 2000 and May 2003.

Results: Length of in-hospital stay (45 +/- 35 days) was the major cost determinant, as hospitalisation accounted for almost 80% of the total costs of the case, with fixed bed-per-day charges amounting to 76% of hospital costs. Factors associated with higher costs were chest X-ray score, fever, sputum bacterial load and multidrug resistance (P < 0.05). Cure/treatment completion was achieved in 82% of patients entering the out-patient programme (63% of all cases). Homelessness, age and comorbidities were associated with unfavourable outcomes.

Conclusions: A closely followed hospital-centred protocol carried out in a high-resource setting may produce acceptable cure/completion treatment rates. As a too high fraction of resources invested in TB control goes toward hospital costs, out-patient treatment strategies should be implemented.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antitubercular Agents / economics
  • Antitubercular Agents / therapeutic use*
  • Female
  • Health Care Costs*
  • Hospitalization / economics*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / economics*
  • Prevalence
  • Retrospective Studies
  • Tuberculosis / epidemiology
  • Tuberculosis / therapy*


  • Antitubercular Agents