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. 2024 Mar 1;1(3):124-129.
doi: 10.5588/ijtldopen.23.0554. eCollection 2024 Mar.

Health system costs of providing outpatient care for diabetes in people with TB in the Philippines

T Yamanaka  1   2 , M C Castro  3 , J P Ferrer  3 , J A Solon  3 , S E Cox  2   4   5 , Y V Laurence  1   6 , A Vassall  1
Affiliations

Health system costs of providing outpatient care for diabetes in people with TB in the Philippines

T Yamanaka et al. IJTLD Open. .

Abstract
in English, French

Background: Diabetes mellitus (DM) is a known risk factor for active TB. A key activity in the Philippines is to integrate TB services with other disease programmes, with a target of DM screening in 90% of TB cases. However, costs of providing DM outpatient services for TB patients are not well known.

Methods: We estimated the costs of providing integrated DM outpatient services within TB services from the health system perspective. Resources for outpatient DM services were valued using the bottom-up approach for capital goods, staff time and consumables. Resource quantities were obtained by interviewing 60 healthcare professionals in 11 health facilities in the Philippines.

Results: The mean cost per service ranged from USD0.53 for DM risk assessment to USD23.72 for oral glucose tolerance test. The cost per case detected for different algorithms varied from USD17.43 to USD80.81. The monthly cost per patient was estimated at USD8.95 to USD12.36.

Conclusion: Our study provides the first estimates of costs for providing integrated DM outpatient services and TB care in a low- and middle-income country. The costs of DM detection in TB patients suggests that it may be useful to further investigate the cost-effectiveness and affordability of service delivery.

Contexte: Le diabète (DM) est un facteur de risque bien établi pour la TB active. Aux Philippines, l'une des principales initiatives est d'intégrer les services de lutte contre la TB dans d'autres programmes de santé, dans le but de dépister le DM chez 90% des patients atteints de TB. Cependant, les coûts des services ambulatoires de traitement du DM pour les patients atteints de TB ne sont pas clairement définis.

Méthodes: Nous avons évalué les coûts des services ambulatoires intégrés pour le traitement du DM dans le cadre des services de lutte contre la TB, du point de vue du système de santé. Les ressources pour les services ambulatoires de DM ont été évaluées en utilisant l'approche ascendante pour les biens d'équipement, le temps du personnel et les consommables. Les quantités de ressources ont été recueillies en interrogeant 60 professionnels de la santé dans 11 établissements de santé aux Philippines.

Conclusion: Notre étude présente les premières estimations des coûts des services ambulatoires intégrés pour le traitement du DM et de soins de la TB dans un pays à revenu faible ou intermédiaire. Il est suggéré d'approfondir l'étude du rapport coût-efficacité et de l'accessibilité des services de détection de la DM chez les patients atteints de TB, compte tenu des coûts impliqués.

Keywords: DM; health system costs; provider costs; tuberculosis.

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Figures

Figure.
Figure.
Cost drivers for providing diabetes outpatient services. Proportions are based on the mean unit cost per diabetes outpatient service. FBS = fasting blood glucose; RPG = random plasma glucose; OGTT = oral glucose tolerance test; HbA1c = glycated haemoglobin.
See this image and copyright information in PMC

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