Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients’ transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.

皮肤利什曼病（Cutaneous leishmaniasis，CL）是一类高发于低收入人群的疾病。因此，在评估该疾病的疾病负担时，将其对个体造成的经济影响纳入考量至关重要。本研究旨在评估巴西米纳斯吉拉斯州某转诊医疗机构收治的皮肤利什曼病患者所承受的疾病经济负担。本研究为横断面研究，通过对访谈资料与医疗记录的分析，从社会视角归集了与皮肤利什曼病相关的直接医疗成本与非医疗成本。本研究共纳入100例患者；其中50%的患者月人均收入不超过259.60美元，患者因该病平均产生医疗相关支出187.32美元，占其月均收入的22.5%（对应绝对金额为133.80美元）。该病产生的直接医疗成本包括：私人诊疗费、药物费用、医学检查费、敷料材料费以及医疗保险共付费用。直接非医疗成本主要为患者前往医疗中心的交通费用（总计4911.00美元），此外还涵盖医疗必需的护理费用、餐食费用以及家政与商务外包服务支出。尽管巴西公共卫生系统保障了患者的就医可及性，但皮肤利什曼病仍对患者造成了显著的经济负担。降低该病相关支出的核心举措包括推进皮肤利什曼病诊断与治疗服务的去中心化布局，同时提升相关服务的运行效率。