A longitudinal study to assess the cost incurred by patients undergoing treatment for tuberculosis in an urban slum community

Objectives: The objective of the study was to estimate direct medical/nonmedical and indirect costs incurred by patients diagnosed with tuberculosis (TB) residing in an urban slum of Mumbai. Subjects and Methods: A longitudinal study of 16 months duration (June 2013-September 2014) was undertaken in a directly observed treatment short-course (DOTS) center of an urban slum area. The method of sampling was universal sampling and thus all the patients who were registered in the period June 2013 to December 2013 were enrolled as study participants. These subjects were then followed for their completion of treatment. All the subjects were interviewed using a semistructured questionnaire to obtain the desired information. Permission from the Institutional Ethics Committee was obtained. Statistical analysis was performed using SPSS software version 19. Results: Of the 232 patients enrolled in the study, 176 (75.9%) completed the entire course of treatment. The median direct, indirect, and total costs for 176 patients were: pretreatment direct medical cost, direct nonmedical cost, and pretreatment indirect cost was Rs. 1200 ($20), Rs. 800 ($13.3), and Rs. 1250 ($20.8), respectively. However, during the course of treatment direct medical cost, direct nonmedical cost, and indirect cost were nil, Rs. 360 ($6) and Rs. 400 ($6.6), respectively. Conclusion: Despite the free availability of diagnostic and treatment component of TB in India, the majority of the tuberculosis patients still have to spend a significant amount of money