Characteristics and economic burden of hospitalized tuberculosis patients in Guangdong Province, China, from 2017 to 2023: a population-based study

BACKGROUND: Tuberculosis, caused by Mycobacterium tuberculosis, remains a leading global health issue, especially in developing countries. In China, tuberculosis prevention efforts have increased, but the disease still imposes significant economic burdens. Guangdong Province, with its dense population and high mobility, faces substantial challenges in tuberculosis control. This study analyzes hospitalization costs and influencing factors to improve resource allocation and policy-making. METHODS: This retrospective study analyzed the data from the first page of medical records in Guangdong Province, including Tuberculosis patients hospitalized in Guangdong Province from 2017 to 2023. Data covered demographics, hospitalization details, and regional classification. Statistical methods included normality tests, chi-square test, Mann-Whitney U and Kruskal-Wallis H tests, and visualization tools such as Sankey charts. Structural variation and new gray relational analyses assessed the relationship between changes in hospitalization costs and each individual cost. Multivariate regression analyzed significant variables affecting costs, and the Prophet model predicted future trends by fitting cost data from 2017 to 2023. RESULT: The study included 410,484 hospitalization records of tuberculosis patients, with a median cost per hospitalization of 8,548.30 RMB. The Pearl River Delta region had higher healthcare costs and longer hospital stays, possibly due to more comorbidity patients. Structural variation analysis and new gray correlation analysis showed that diagnostic and western medicine fees had the main contribution to changes in hospitalization costs. Multivariate regression analysis showed that hospital class drug resistance and surgery were the main factors affecting hospitalization costs. The Prophet model predicted that hospitalization costs would decrease over the next three years due to improved Tuberculosis control measures and policy adjustments. CONCLUSIONS: This study reveals the economic burden and regional differences of hospitalized Tuberculosis patients in Guangdong Province. Diagnostic costs and western drug costs are the main factors contributing to changes in hospitalization costs, with hospital class, drug resistance and surgery being the main influences, while hospitalization costs will decline over the next three years. Therefore, investing in primary care to improve local healthcare access, empowering providers to manage tuberculosis effectively, optimizing treatment policies, expanding health insurance coverage, and enhancing drug-resistant patient treatment are critical to reducing financial burdens and improving tuberculosis control.