Assessment of the Impact of Heart Failure on Household Economic Well-being: Background and Methods-Punjabi version

Background and rationale: Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. The potential adverse impact of HF on the economic well-being of affected individuals and their families is narrated in various anecdotal reports. Further, HF is known to push the affected individuals and their dependents into poverty. However, there is limited research quantifying how HF impacts the economic well-being of households from the low and middle-income countries. Methods: We describe the methods of a detailed economic impact assessment of HF at the household level in India. The economic impact study in HF is initiated across 20 centres in India. The selected centres represent different regions in India stratified based on the prevailing stage of epidemiological transition levels (ETLs). We will collect data from 1800 patients with acute decompensated HF and within 6-15 months of follow-up from the time of initial admission. The data that we intend to collect will consist of a) household healthcare expenditure including out-of-pocket expenditure, b) financing mechanisms used by households and (c) the impoverishing effects of health expenditures including distress financing and catastrophic health expenditure. Trained staff at each centre will collect relevant data by using a validated and structured interview schedule. The study will have 80% power, after accounting for five percent non-response rate, to test eight percent difference in primary outcome (proportion of families under distress financing) between different ETLs. Impact: The results from the study will help policy makers in understanding the micro-economic impact of HF in India and aid in allocation of appropriate resources for prevention and control of HF.