Bengey, D. et al. (2023) Comparing cross-sectional and longitudinal approaches to tuberculosis patient cost surveys using Nepalese data. Health Policy and Planning, 38(7), pp. 830-839. (doi: 10.1093/heapol/czad037) (PMID:37300553) (PMCID:PMC10394499)
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Abstract
The World Health Organization has supported the development of national tuberculosis (TB) patient cost surveys to quantify the socio-economic impact of TB in high-burden countries. However, methodological differences in the study design (e.g. cross-sectional vs longitudinal) can generate different estimates making the design and impact evaluation of socio-economic protection strategies difficult. The objective of the study was to compare the socio-economic impacts of TB estimated by applying cross-sectional or longitudinal data collections in Nepal. We analysed the data from a longitudinal costing survey (patients interviewed at three time points) conducted between April 2018 and October 2019. We calculated both mean and median costs from patients interviewed during the intensive (cross-sectional 1) and continuation (cross-sectional 2) phases of treatment. We then compared costs, the prevalence of catastrophic costs and the socio-economic impact of TB generated by each approach. There were significant differences in the costs and social impacts calculated by each approach. The median total cost (intensive plus continuation phases) was significantly higher for the longitudinal compared with cross-sectional 2 (US$119.42 vs 91.63, P < 0.001). The prevalence of food insecurity, social exclusion and patients feeling poorer or much poorer were all significantly higher by applying a longitudinal approach. In conclusion, the longitudinal design captured important aspects of costs and socio-economic impacts, which were missed by applying a cross-sectional approach. If a cross-sectional approach is applied due to resource constraints, our data suggest that the start of the continuation phase is the optimal timing for a single interview. Further research to optimize methodologies to report patient-incurred expenditure during TB diagnosis and treatment is needed.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding: The dataset used in this study was acquired from the IMPACT TB project funded by European Union, Horizon 2020 (grant number: 733174) and TB REACH WAVE 5 funded by Stop TB Partnership (grant number: 5-31). EK is funded by Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Kibuchi, Dr Eliud |
| Authors: | Bengey, D., Thapa, A., Dixit, K., Dhital, R., Rai, B., Paudel, R., Majhi, G., Aryal, T. P., Sah, M. K., Pandit, R. N., Paudel, P., Khanal, M. N., Mishra, G., Kibuchi, E., Caws, M., and de Siqueira-Filha, N. T. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Health Policy and Planning |
| Publisher: | Oxford University Press |
| ISSN: | 0268-1080 |
| ISSN (Online): | 1460-2237 |
| Published Online: | 10 June 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Health Policy and Planning 38(7): 830-839 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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