Table 5. Likelihood of incurring catastrophic cost using HCA2 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) | 1.02 (1.00, 1.04) | 0.06 | 1.01 (0.99, 1.03) | 0.27 | 1.02 (1.00, 1.03) | 0.12 | 1.01 (1.00, 1.02) | 0.04 |
| Sex | ||||||||
| Male (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Female | 1.18 (0.65, 2.14) | 0.58 | 1.64 (0.94, 2.86) | 0.08 | 1.58 (0.98, 2.56) | 0.06 | 1.49 (1.11, 2.02) | 0.01 |
| Education | ||||||||
| Up to primary education (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Secondary education | 1.07 (0.56, 2.06) | 0.84 | 0.65 (0.35, 1.12) | 0.16 | 1.29 (0.68, 2.44) | 0.43 | 0.80 (0.57, 1.12) | 0.19 |
| Higher secondary education and above | 0.48 (0.22, 1.04) | 0.06 | 0.60 (0.27, 1.34) | 0.21 | 0.54 (0.20, 1.45) | 0.22 | 0.62 (0.40, 0.98) | 0.04 |
| 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 | 0.06 (0.03, 0.13) | <0.001 | 0.15 (0.08, 0.28) | <0.001 | 0.21 (0.12, 0.36) | <0.001 | 0.14 (0.10, 0.19) | <0.001 |
| 200,000 and above | 0.01 (0.00, 0.02) | <0.001 | 0.03 (0.01, 0.06) | <0.001 | --- | 0.03 (0.02, 0.06) | <0.001 | |
| Health insurance | ||||||||
| Having health insurance (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Not having health insurance | 1.22 (0.65, 2.30) | 0.54 | 1.03 (0.53, 1.99) | 0.93 | 1.00 (0.60, 1.66) | 1.00 | 1.02 (0.74, 1.41) | 0.90 |
| Type of TB | ||||||||
| Pulmonary TB (Reference) | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Extrapulmonary TB | 1.54 (0.82, 2.91) | 0.18 | 2.12 (1.18, 3.81) | 0.01 | 1.29 (0.76, 2.21) | 0.35 | 1.71 (1.24, 2.35) | 0.00 |
| Delay from symptom initiation to treatment | 1.02 (0.99, 1.05) | 0.22 | 1.01 (0.98, 1.04) | 0.63 | 1.01 (0.98, 1.04) | 0.41 | 1.01 (1.00, 1.03) | 0.08 |
| Direct cost of TB treatment (Log cost) * | 11.87 (7.23, 19.48) | <0.001 | 7.48 (4.91, 11.37) | <0.001 | 1.98 (1.60, 2.45) | <0.001 | 4.00 (3.33, 4.77) | <0.001 |
| Residential status | ||||||||
| Urban (Reference) | 1.00 | --- | --- | 1.00 | ||||
| Rural | 0.69 (0.38, 1.24) | 0.21 | 0.98 (0.71, 1.35) | 0.89 | ||||
| Wealth quintile | ||||||||
| Poorest (Reference) | --- | --- | --- | 1.000 | ||||
| Poorer | 0.66 (0.43, 1.04) | 0.07 | ||||||
| Middle | 0.63 (0.41, 0.99) | 0.04 | ||||||
| Richer | 0.73 (0.47, 1.14) | 0.16 | ||||||
| Richest | 0.40 (0.24, 0.67) | <0.001 | ||||||
| Adjusted R2 ** | 0.47 | 0.41 | 0.20 | 0.35 | ||||
Notes: HCA2: Human capital approach where hours spent was calculated using combination of patient wage and minimum wage 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