Economic Burden of Diabetic Tuberculosis Patients from 3 Malaysian Hospitals | Chapter 15 | Innovations in Medicine and Medical Research Vol. 1
Aim:
To assess the impact of diabetes mellitus (DM) on the cost of the tuberculosis
(TB) treatment.
Study
Design: Prevalence based cohort.
Place
and Duration of Study: Penang General Hospital, Hospital USM,
and – Univesiti Malaya Medical Center; 2005 – 2008.
Methods:
Study patients were placed in the TB only, DM only, or DM-TB groups, with each
group including 200 patients. Information related to demographics, chronic
disease comorbidity, duration of hypertension (HTN) and DM, and economic
variables were obtained from the patients’ medical files both at the beginning
and end of the study period. The economic burden of DM-TB patients was assessed
from hospitalization periods, frequency of clinic visits, and diagnostic
requests.
Results:
Durations of DM and HTN were 9.2 and 5.6 years, respectively, for the DM only
group compared to 5.3 and 1.1 years, respectively, for DM-TB subjects. For both
diabetic groups, diabetes preceded HTN, with onset of HTN occurring
approximately 4 years after patients were diagnosed diabetic. Approximately 86%
of DM only subjects suffered additional comorbidity, and 44.5% had three or
more coexisting chronic diseases compared to 56% and 11.4%, respectively, in
the DM-TB group. The hospitalization period was 10.2 days for the DM-TB group
compared to 7 and 4 days for the TB only and DM only groups, respectively;
however, 43% of TB only subjects needed surgical intervention compared to 17%
in the DM-TB group. The total cost wasRM4530 (US$1234.3) for the DM-TB group
compared to RM3082.8 (US$840) and RM6945.26 (US$1892.40) for the TB only and DM
only groups, respectively.
Conclusions:
DM antedated HTN in our patients. Durations of both DM and HTN were longer for
the DM only group. The number of diagnosed chronic diseases and overall
treatment cost was higher in the DM-TB group compared to TB only group, but
lower compared to the DM only group. The TB only group required the most
surgical intervention.
Author(s) Details
Daud M. I. Aweis
Pharmacy and Medical Supply
Division, Ahmadi Hospital, Kuwait Oil Company, Kuwait and School of
Pharmaceutical Sciences, USM, 11800 Penang, Malaysia.
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