Table 3. Major item costs >0 incurred in every stage of the patient care pathway (in USD).

Category	Sub-category	Occurrence	Direct cost(in USD), All	Direct cost(in USD), Urban	Direct cost(in USD), Rural	Regionaldifference
Stage of carepathway	Cost items	% of patients	Median (iqr, n)	Median (iqr, n)	Median (iqr, n)	P-value
Pre-diagnosis	Traditional healer	25.3	30.1 (10.5–83.0, 62)	31.1 (12.4–103.7, 39)	24.9 (4.1–51.9, 23)	0.1635
	Self-medicationand spiritual remedy	68.6	14.5 (7.2–41.5, 168)	20.74 (9.8–62.2, 100)	10,4 (6.2–20.7, 68)	0.0023
	Travel costs	59.2	10.4 (4.1–31.1, 145)	9.0 (3.3–24.9, 95)	11.0 (7.3–47.7, 50)	0.0523
Diagnosis	Medication	38.4	31.1 (10.4–77.3, 94)	31.1 (13.5–103.7, 38)	22.8 (7.8–57.0, 56)	0.1913
	Sputum-smear microscopy	62.0	1.0 (1.0–1.0, 152)	1.0 (1.0–1.0, 145)	1.2 (1.0–1.2, 7)	<0.0001
	Chest X-rays	60.4	6.2 (6.2–6.2, 148)	6.2 (6.2–6.2, 135)	10.4 (9.3–21.8, 13)	<0.0001
	Other medical costs(fees, additionalexamination)	78.4	2.1 (2.1–2.1, 192)	2.1 (2.1–2.1, 135)	1.5 (1.0–8.3, 57)	0.0858
	Travel costs	82.0	4.1 (2.1–10.4, 201)	3.4 (2.1–6.2, 121)	6.7 (3.7–20.7, 80)	<0.0001
Treatmentinitiation	All costs	75.1	2.1 (1.0–4.1, 184)	1.7 (1.0–3.7, 123)	2.1 (1.2–4.1, 61)	0.3905
Intensivetreatment	Medical costs	27.3	10.0 (3.7–20.7, 67)	10.0 (4.1–19.7, 53)	7.2 (3.1–20.7, 14)	0.7812
	Travel and food	89.0	41.5 (17.6–92.9, 218)	52.7 (20.7–112.0, 149)	31.1 (14.5–55.5, 69)	0.0008
Continuationtreatment	Medical costs	4.6	12.4 (7.3–20.5, 7)	12.4 (8.3–17.6, 5)	12.4 (4.3–20.4, 2)	–
	Travel and food	81.0	16.7 (4.1–66.9, 124)	31.1 (4.6–95.8, 77)	10.4 (3.1–38.6, 47)	0.0126

Most patients accumulated medical or non-medical out-of-pocket expenses at every single stage of their care pathways. The greater burdens relied on non-medical expenses during pre-diagnosis (traditional spending) and during intensive treatment (travel and food) while medical expenses were dominant during diagnosis stage. At the regional level, disparities between urban and rural residents were concentrated on the non-medical expenses.