Analysis of hospitalization costs for pulmonary and extrapulmonary tuberculosis patients from a designated infectious-disease hospital in Guizhou Province, Southwest China: a quantile regression analysis

Evidence on inpatient-related costs for tuberculosis (TB) patients remains limited for Southwest China. This study used quantile regression to explore factors associated with inpatient expenditures among TB patients treated at a designated infectious-disease hospital in Guizhou Province, Southwest China. Baseline characteristics and inpatient cost data of TB patients admitted to a designated infectious disease hospital in Guizhou Province from January 2018 to December 2024 were retrospectively collected. Quantile regression models were applied to identify determinants of inpatient costs across different cost distributions. The findings showed that, at lower cost quantiles, self pay patients had lower inpatient costs (10th percentile; coefficient = −141.79). Conversely, patients covered by social basic medical insurance had significantly lower inpatient costs at higher cost quantiles (90th percentile; coefficient = −97 404.08). Manual labor workers and retirees had higher inpatient costs across the 10th to 90th percentiles compared with other occupational groups. Inpatient length of stay, receipt of interventional procedures, drug resistance, admission status, and comorbidities were positively associated with inpatient costs across the 10th to 90th percentiles (all P < 0.001). Cost differences existed across quantiles for different TB types: disseminated TB produced the highest costs at the 10th percentile (coefficient = 1367.35), while tuberculous meningitis incurred the highest costs from the 50th to the 90th percentiles. According to the relative importance ranking, the most influential factors (in descending order) were length of stay, admission status, TB type, procedural intervention, and occupational factors. Based on seven year consecutive inpatient data, this study indicates that TB inpatient expenditures are affected by multiple factors and differ across cost quantiles. Targeted cost containment strategies should be developed according to patient characteristics to reduce medical expenses and shorten hospital stays without impairing treatment outcomes. These findings provide theoretical evidence for formulating TB cost control policies for similar hospital settings. Caution should be exercised when generalizing these results to all TB patients across Southwest China given the single center study design.