A eureka moment - using coalface data for discovery on TB disease and financial relief

Background: Although Australia maintains a low incidence of TB, elimination remains elusive. To support program delivery and evaluation, intervention fidelity, trends and patterns in the provision of financial relief were explored. Insights for practitioners and funders inform decision-making.

Methods: Data and process mining approaches were used to explore the dispersal of vouchers and small grants processed through the Victorian Tuberculosis Program. Data sources identified, curated, and analysed included financial relief dispersal records and public health documentation (sociodemographic, TB, and health care access characteristics). Queries and analysis were shaped through practitioner consultation.

Results: Of 3,811 TB events, 15% received financial relief during treatment. Relief recipients were younger, more often male, and more likely to have pulmonary disease and cavitation. Twice as likely to be part of whole genome sequencing-defined transmission clusters, recipients also experienced more treatment interruptions. Practitioner insights revealed that financial relief functioned as a response to hardship and as an enabler or incentive to support engagement with care.

Conclusion: The observed patterns and trends suggest an intersection between TB vulnerability and financial relief. Low-incidence, high-income settings likely benefit from financial relief to mitigate structural inequities. Further research should detail the nature of financial hardship, co-occurring indicators of TB, and their proximity to TB care outcomes.