Table 4. Likelihood of incurring catastrophic cost using HCA1 method of indirect cost calculation.
| General population (N = 528) | Urban slum dwellers (N = 526) | Tea garden families (N = 403) | All participants (N = 1457) | |||||
|---|---|---|---|---|---|---|---|---|
| Explanatory variables | Adjusted OR (95% CI) | p-value | Adjusted OR (95% CI) | p-value | Adjusted OR (95% CI) | p-value | Adjusted OR (95% CI) | p-value |
| Age (in years) | 1.01 (0.99, 1.03) | 0.18 | 1.01 (0.99, 1.03) | 0.22 | 1.01 (1.00, 1.03) | 0.28 | 1.01 (1.00, 1.02) | 0.05 |
| Sex | ||||||||
| Male (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Female | 1.06 (0.66, 1.70) | 0.80 | 1.59 (0.91, 2.77) | 0.10 | 1.34 (0.85, 2.12) | 0.21 | 1.34 (1.02, 1.76) | 0.04 |
| Education | ||||||||
| Up to primary education (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Secondary education | 0.99 (0.59, 1.67) | 0.98 | 0.63 (0.34, 1.16) | 0.13 | 1.19 (0.64, 2.20) | 0.58 | 0.80 (0.58, 1.10) | 0.17 |
| Higher secondary education and above | 0.48 (0.26, 0.88) | 0.02 | 0.62 (0.28, 1.37) | 0.23 | 0.57 (0.22, 1.48) | 0.24 | 0.61 (0.40, 0.91) | 0.02 |
| Pre-TB annual household income (Indian Rupee) | ||||||||
| Less than 100,000 (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| 100,000 –less than 200,000 | 0.13 (0.07, 0.23) | <0.001 | 0.14 (0.08, 0.27) | <0.001 | 0.19 (0.11, 0.31) | <0.001 | 0.16 (0.11, 0.21) | <0.001 |
| 200,000 and above | 0.06 (0.03, 0.12) | <0.001 | 0.03 (0.01, 0.06) | <0.001 | --- | 0.07 (0.05, 0.11) | <0.001 | |
| Health insurance | ||||||||
| Having health insurance (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Not having health insurance | 1.44 (0.88, 2.34) | 0.15 | 1.03 (0.53, 1.99) | 0.93 | 0.97 (0.60, 1.58) | 0.91 | 1.11 (0.83, 1.50) | 0.48 |
| Type of TB | ||||||||
| Pulmonary TB (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Extrapulmonary TB | 1.54 (0.95, 2.50) | 0.08 | 2.21 (1.23, 3.98) | 0.01 | 1.21 (0.72, 2.03) | 0.48 | 1.68 (1.25, 2.26) | <0.001 |
| Delay from symptom initiation to treatment | 1.01 (0.99, 1.03) | 0.41 | 1.01 (0.98, 1.04) | 0.625 | 1.01 (0.98, 1.04) | 0.44 | 1.01 (1.00, 1.03) | 0.08 |
| Direct cost of TB treatment (Log cost) * | 2.88 (2.22, 3.74) | <0.001 | 7.37 (4.85, 11.21) | <0.001 | 1.70 (1.41, 2.05) | <0.001 | 2.66 (2.30, 3.06) | <0.001 |
| Residential status | ||||||||
| Urban (Reference) | 1.00 | --- | --- | 1.00 | ||||
| Rural | 0.90 (0.57, 1.42) | 0.66 | 1.27 (0.95, 1.70) | 0.11 | ||||
| Wealth quintile | ||||||||
| Poorest (Reference) | --- | --- | --- | 1.00 | ||||
| Poorer | 0.68 (0.45, 1.02) | 0.06 | ||||||
| Middle | 0.64 (0.42, 0.96) | 0.03 | ||||||
| Richer | 0.71 (0.47, 1.08) | 0.11 | ||||||
| Richest | 0.55 (0.35, 0.88) | 0.01 | ||||||
| Adjusted R2 ** | 0.31 | 0.41 | 0.19 | 0.29 | ||||
Notes: HCA1: Human capital approach where hours spent was calculated using minimum wage rate for all and household income as denominator; OR: Odds Ratio; CI: Confidence Interval; Blanks indicate Not Applicable;
* One patient among general population and 24 patients among tea garden families did not incur any direct cost, hence, were excluded from this analysis;
**Cox and Snell R2