Direct economic burden of patients with tuberculous meningitis in western China.
OBJECTIVE
To estimate the direct economic burden of tuberculous meningitis (TBM) in China for the first time.


METHODS
Patients who were first diagnosed with TBM from December 2015 to December 2018 in Western China Hospital were enrolled. We retrospectively collected data on demographic and clinical features, resource utilization, costs, and long-term outcomes. The patients were followed up for 15-53 months. We performed a cost-of-illness study and analyzed the cost contributors with a generalized linear model.


RESULTS
In total, the cases of 154 TBM patients (95 males, 59 females, aged 14-82 years) were reviewed. The average total direct cost per person was USD (United States dollars) 9,484 (range 1,822-67,285), with a mean direct medical cost of USD 8,901 (range 1,189-67,049). The average inpatient cost and drug cost after discharge were USD 6,837 (range 845-52,921) and USD 1,967 (range 0-60,423), respectively. The mean direct nonmedical cost was USD 583 (range 33-3,817), which accounted for 6.2% of the total direct cost. The average length of stay (LOS) in hospital was 25.0 days (range 6-152). A total of 117 of the patients (76.0%) had good outcomes (mRS = 0-2). There was no significant difference in the costs, LOS, or outcomes between rural and urban patients. Contributors to total direct cost were definite TBM, fever, coma, seizures, multidrug resistance, hydrocephalus, and poor long-term outcome.


CONCLUSIONS
Although the accessibility of medical resources in remote and rural regions has significantly improved in China, the cost of TBM imposes a catastrophic burden on patients.
['Ma|Xue-Ping|XP|', 'Li|Jin-Mei|JM|https://orcid.org/0000-0002-7411-8269', 'Zhou|Dong|D|https://orcid.org/0000-0001-7101-4125', 'Yang|Rong|R|']
D002681:China D017281:Cost of Illness D005260:Female D006801:Humans D007902:Length of Stay D008297:Male D012189:Retrospective Studies D014390:Tuberculosis, Meningeal D014481:United States
tuberculous meningitis China outcome direct cost