Search

Objective: To estimate the expenditure incurred towards treatment of an episode of respiratory infection among under-fives in outpatient and inpatient departments of primary and secondary level health facilities.Methods: During March 2011 - September 2012, under-five children presenting with febrile acute respiratory infection (FARI) in the outpatient (OPD) and inpatient (IPD) departments of public and private health facilities of Ballabgarh, Haryana were enrolled in the study. Children who were free from co-morbidities and whose contact number or proper address were available, were enrolled and followed up over telephone or by house visits till recovery. Information was collected on expenditure incurred towards treatment of FARI. Work loss of each day was valued as per capita national income per day. Cost of service in public facilities were supplemented by WHO-CHOICE estimates. The cost of respiratory episode in different settings are expressed in median and inter quartile range (IQR).Results: One hundred fourteen children from OPD and 75 from IPD were enrolled and followed up till recovery. Among eligible children 40% and 20% in OPD and IPD were excluded respectively as they could not provide address or contact number. The median costs of an episode treated in OPD and IPD were INR 447(IQR: INR 294-669) and INR 7506.06 (IQR: INR 3765-10,406) respectively.Conclusions: Respiratory infections are responsible for substantial economic burden, especially with huge proportion of out-of-pocket expenditure. Total cost of a respiratory episode that required hospitalization was 1.5 times the per capita monthly income of an Indian. [ABSTRACT FROM AUTHOR]

Background: Despite the high mortality and morbidity resulting from acute respiratory infections (ARI) globally, there are few data from low-income countries on costs of ARI to inform public health policy decisions We conducted a prospective survey to assess costs of ARI episodes in selected primary, secondary, and tertiary healthcare facilities in north India where no respiratory pathogen vaccine is routinely recommended. Methods: Face-to-face interviews were conducted among a purposive sample of patients with ARI from healthcare facilities. Data were collected on out-of-pocket costs of hospitalization, medical consultations, medications, diagnostics, transportation, lodging, and missed work days. Telephone surveys were conducted two weeks after medical encounters to ask about subsequent missed work and costs incurred. Costs of prescriptions and diagnostics in public facilities were supplemented with WHO-CHOICE estimates of hospital bed costs. Missed work days were assigned cost based on the national annual per capita income (US$1,104). Non-medically attended ARI cases were identified from an ongoing community-based ARI surveillance project in Faridabad. Results: During September 2012-March 2013, 1766 patients with ARI were enrolled, including 451 hospitalized patients, 1056 outpatients, and 259 non-medically attended patients. The total direct cost of an ARI episode requiring outpatient care was US$4- $6 for public and $3-$10 for private institutions based on age groups. The total direct cost of an ARI episode requiring hospitalized care was $54-$120 in public and $135-$355 in private institutions. The cost of ARI among those hospitalized was highest among persons aged > = 65 years and lowest among children aged < 5 years. Indirect costs due to missed work days were 16-25% of total costs. The direct out-of-pocket cost of hospitalized ARI was 34% of annual per capita income. Conclusions: The cost of hospitalized ARI episodes in India is high relative to median per capita income. Data from this study can inform evaluations of the cost effectiveness of proven ARI prevention strategies such as vaccination. [ABSTRACT FROM AUTHOR]