Age-specific clinical profiles and economic burden of pediatric tuberculosis: a 5-year retrospective study in central China.
Xiaojun Wang, Cuili Yang, Meilan Zhou, Cuiping Xiao, Xiaolu Yu, Qian Fu
BMC infectious diseases · 2026-02
Abstract
BACKGROUND: Research on the economic burden of pediatric tuberculosis (TB) remains scarce. This study aims to investigate the hospitalization characteristics, direct medical expenses, and key determinants of hospitalization costs in pediatric TB patients.
METHODS: We conducted a retrospective analysis of the hospitalization information system of a tertiary specialized tuberculosis hospital in Hubei Province, China. We extracted hospitalization records of pediatric TB patients aged 0–14 years who were admitted between January 2018 and December 2022. Multivariable logistic regression analysis was employed to analyze the determinants of hospitalization expenses, using a binary outcome variable defined by whether the total hospitalization cost exceeded the median value.
RESULTS: A total of 401 hospitalized pediatric TB cases were enrolled, with patients aged 0–4 years, 5–9 years, and 10–14 years accounting for 19.9%, 15.5%, and 64.6%, respectively. The median total hospitalization cost was 10,608 CNY (1485 USD), and the median out-of-pocket expense was 9248 CNY (1295 USD). Notably, the 10–14 years group had significantly higher median total hospitalization cost (12963 CNY, 1815 USD) and median out-of-pocket expense (10431 CNY, 1460 USD) than the 0–4 years group (8539 CNY, 1195 USD; 8124 CNY, 1137 USD, respectively) and 5–9 years group (8192 CNY, 1147 USD; 7180 CNY, 1005 USD, respectively, all < 0.0001). Multivariable logistic regression analysis revealed that older age (10-14years: OR = 3.18, 95%CI: 1.02–9.90), surgical treatment (OR = 10.66, 95%CI: 4.91–23.13), multiple hospitalizations (2 hospitalizations: OR = 6.13, 95%CI: 2.43–15.51; ≥3 hospitalizations: OR = 17.81, 95%CI: 3.96–80.03), and longer hospital stays (OR = 11.04, 95%CI: 5.55–21.96) significantly increased hospitalization expenses.
CONCLUSIONS: Pediatric TB patients experience significant economic burden due to high overall hospitalization costs and substantial out-of-pocket expenses. Targeted interventions are urgently needed, including expanding medical insurance coverage for pediatric-specific anti-TB drugs and diagnostic items, and standardizing clinical diagnosis and treatment processes to reduce unnecessary medical expenditures.
CLINICAL TRIAL NUMBER: Not applicable.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-026-12932-4.