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. Author manuscript; available in PMC: 2017 May 25.
Published in final edited form as: J Health Care Poor Underserved. 2002 Aug;13(3):392–401. doi: 10.1353/hpu.2010.0708

TABLE 2.

NET BENEFITS TO U.S. TAXPAYERS OF ELIMINATING TUBERCULOSIS (TB) HOSPITALIZATIONS IN PERSONS AT HIGH RISK FOR TB HOSPITALIZATION

DAYS/PATIENT
COST/PATIENT/DAY (1999 DOLLARS)
TOTAL U.S. COST (1999 DOLLARS)
STUDY PATIENTS U.S. PATIENTSa FIRST QUARTILE MEDIAN AVERAGE THIRD QUARTILE FIRST QUARTILE MEDIAN AVERAGE THIRD QUARTILE FIRST QUARTILE MEDIAN AVERAGE THIRD QUARTILE
Direct
 Hospital procedures/medications 490 7,538 7 13 27 25 489 623 736 877 25,802,574 61,050,262 149,795,136 165,270,650
 Physician 490 7,538 7 13 27 25 21 21 21 21 1,108,086 2,057,874 4,274,046 3,957,450
Total direct costs 510 644 757 898 26,910,660 63,108,136 154,069,182 169,228,100
Indirect
 Productivity losses 490 7,538 7 13 27 25 93.11 93.11 93.11 93.11 4,913,042 9,124,221 18,950,306 17,546,580
Total indirect costs 93 93 93 93 4,913,042 9,124,221 18,950,306 17,546,580
Total direct and indirect costs 603 737 850 991 31,823,702 72,232,357 173,019,488 186,774,680
Costs of preventing TB hospitalizations
 Targeting testing and treatment for latent TB infectionb 490 7,538 270 270 270 270 1 1 1 1 2,035,260 2,035,26 2,035,260 2,035,260
 Housing/food/social worker for homelessc 96 1,477 270 270 270 270 21 21 21 21 8,374,590 8,374,590 8,374,590 8,374,590
 Directly observed treatment two times a week for nine monthsd 490 7,538 72 72 72 72 42 42 42 42 22,794,912 22,794,912 22,794,912 22,794,912
 Liver exams in HIV-positive patientse 117 1,800 9 9 9 9 19 19 19 19 307,800 307,800 307,800 307,800
 Anti-AIDS medicationsf 117 1,800 270 270 270 270 41 41 41 41 19,926,000 19,926,000 19,926,000 19,926,000
 Substance abuse treatmentg 277 4,262 270 270 270 270 13 13 13 13 14,959,620 14,959,620 14,959,620 14,959,620
Total costs of prevention 124 124 124 124 68,398,182 68,398,182 68,398,182 68,398,182
Net benefits to U.S. taxpayers 479 613 726 867 (36,574,480) 3,834,175 104,621,306 118,376,498

Note: This table shows the costs of eliminating TB hospitalizations in high-risk persons (homeless, HIV-positive, non-Hispanic blacks, substance abusers, correctional facility residents, multidrug resistant TB patients, or long-term care residents paid for by the public sector or uninsured in public hospitals).

a

Since the study patients represented 6.5 percent of U.S. TB patients, U.S. patients = study patients divided by 6.5 percent.

b

Costs of TB testing (tuberculin skin test [TST], follow-up TST, chest radiograph, sputum exam) and treatment for latent TB infection (nine months of isoniazid or four months of rifampin).

c

Nine months of housing (fair market rent for two bedroom $415 adjusted to 80 percent for an efficiency), food (U.S. Stat Abstract Table 760 liberal plan adjusted upward by 20 percent for a single male), and one day of $35,000 annual salary social worker.

d

Cost of directly observed treatment.

e

Nine monthly liver enzyme exams.

f

Nine months of anti-AIDS medications at $15,000 per year, estimate.

g

Nine months of outpatient substance abuse treatment.