Cost of Treatment of Febrile Acute Respiratory Infection (FARI) Among Under-Five Children Attending Health Facilities of Ballabgarh, Haryana

Purakayastha, Debjani Ram; Kumar, Sanjay; Broor, Shobha; Krishnan, Anand

doi:10.1007/s12098-017-2420-3

Cited by 3 publications

(6 citation statements)

References 15 publications

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“…The results from our study show that approximately one-third of the total cost is contributed by indirect cost which is similar to findings from studies done in India and Bangladesh [ 32 , 33 ]. The indirect cost does not include travel and living expenses and therefore the out-of-pocket expenditures of parents/guardians in the present study is likely to be higher.…”

Section: Discussionsupporting

confidence: 91%

“…The bed charges, the largest component of direct costs, depended on which ward the infant was admitted to and the length of hospital stay. Our study is similar to studies in India and Bangladesh [ 32 , 33 ], where the bed charges account for significant cost of treatment of hospitalized children. Neonates at KCH are admitted to the NIMCU and shifted to NICU if they require advanced support.…”

Section: Discussionsupporting

confidence: 88%

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Assessment of hospitalization costs and its determinants in infants with clinical severe infection at a public tertiary hospital in Nepal

et al. 2021

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Sepsis, an important and preventable cause of death in the newborn, is associated with high out of pocket hospitalization costs for the parents/guardians. The government of Nepal’s Free Newborn Care (FNC) service that covers hospitalization costs has set a maximum limit of Nepalese rupees (NPR) 8000 i.e. USD 73.5, the basis of which is unclear. We aimed to estimate the costs of treatment in neonates and young infants fulfilling clinical criteria for sepsis, defined as clinical severe infection (CSI) to identify determinants of increased cost. This study assessed costs for treatment of 206 infants 3–59 days old, enrolled in a clinical trial, and admitted to the Kanti Children’s Hospital in Nepal through June 2017 to December 2018. Total costs were derived as the sum of direct costs for bed charges, investigations, and medicines and indirect costs calculated by using work time loss of parents. We estimated treatment costs for CSI, the proportion exceeding NPR 8000 and performed multivariable linear regression to identify determinants of high cost. Of the 206 infants, 138 (67%) were neonates (3–28 days). The median (IQR) direct costs for treatment of CSI in neonates and young infants (29–59 days) were USD 111.7 (69.8–155.5) and 65.17 (43.4–98.5) respectively. The direct costs exceeded NPR 8000 (USD 73.5) in 69% of neonates with CSI. Age <29 days, moderate malnutrition, presence of any sign of critical illness and documented treatment failure were found to be important determinants of high costs for treatment of CSI. According to this study, the average treatment cost for a newborn with CSI in a public tertiary level hospital is substantial. The maximum limit offered for free newborn care in public hospitals needs to be revised for better acceptance and successful implementation of the FNC service to avert catastrophic health expenditures in developing countries like Nepal. Trial Registration: CTRI/2017/02/007966 (Registered on: 27/02/2017).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Assessment of hospitalization costs and its determinants in infants with clinical severe infection at a public tertiary hospital in Nepal

et al. 2021

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“…In another study, there was high OOP expense which may be due to the study participants being the general population. [ 13 ] In a study by Pradhan et al . on the IPD expense, the direct expense was ₹7015.00 and indirect expenses were ₹5190.00 for febrile illness in a tertiary hospital.…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 ] The median expense incurred for fever and respiratory illness among U5C visiting a healthcare center in Haryana, India in OPD was ₹447.00 and IPD was ₹7506.00. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Out-of-pocket expenditure and its predictors for illness of under-five children: A cross-sectional study in urban slums of Eastern India

Patnaik

Mohanty

Satpathy

et al. 2021

J Family Med Prim Care

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Introduction: Out-of-pocket (OOP) expenditure influences the access to the healthcare of the marginalized and vulnerable population including under-five children (U5C). The aim of the study is to estimate the OOP expenditure and its predictors in Bhubaneswar, a region of eastern India. Methods: A cross-sectional study was conducted using a semi-structured interview schedule in 20 urban slums of Bhubaneswar. The survey was carried out by using the National Sample Survey Office (NSSO) health consumption schedule 25.0 in which mothers of U5C with illness (n = 530) were interviewed. For data analysis, the nonparametric Wilcoxon rank-sum test and Kruskal–Wallis test were used as tests of significance. Results: The study revealed that the mean OOP expenditure for outpatient department (OPD) care was ₹375.9 (₹219.48). The mean approximated expenditure was ₹1669.8 (₹1131.9) for inpatient department (IPD) care. In OPD care, doctors' fee and medicine cost constituted 65.01% and 50.46% of OOP expenditure, respectively. In IPD care, medicine cost and doctors' fee contributed to 36.62% and 30.54% of OOP expenditure, respectively. The major significant predictors that contributed to increased OOP were gender and delay in approaching the source of treatment in OPD, whereas in IPD no such predictors were observed. Conclusions: This study prominently sheds light on the issue of accessibility and affordability of health services without a comprehensive health insurance scheme for U5C illness among the vulnerable urban slum dwellers to achieve universal health coverage.

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“…Whether this amount is more or less is difficult to comment on account of: (1) limited cost analysis study on febrile illnesses, (2) different objectives and methods adopted in different studies and different types of health facilities, (3) cost studies of single underlying disease with manifestation of fever such as typhoid fever and acute respiratory illness, and (4) health facilities are not tuned to undertake this type of studies. [101112]…”

Section: Discussionmentioning

confidence: 99%

Costing of febrile illness among under five children, a study in a tertiary care teaching hospital in Odisha, India

Pradhan

Mohakud

Pugalia

et al. 2019

J Global Infect Dis

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Objective:The objective of this study was to determine the cost of treatment, both direct and indirect costs, of febrile illness among under-five children in Odisha, India.Methods:This was a cross-sectional study of thirty under-five children with febrile illness reporting to the pediatric outpatient (OP) department and thirty more under-five children admitted to the pediatric ward who were included in the study during January–April 2018. The parents/caretakers of the ailing children were interviewed using the WHO questionnaire contextualized to the local situation. Both direct (medicine, diagnostics, registration/doctor's fees, bed charges, and cost of personal medical appliances) and indirect (transportation, food, loss of income, and lodging) costs of febrile illness and pre-, during, and posthospital visit cost were estimated.Results:The median direct and indirect costs for OP cases were Rs. 1201.00 and Rs. 1375.00, respectively. For the hospitalization (indoor patients), direct and indirect costs were Rs. 7015.00 and Rs. 5190.00, respectively. People also spent money in pre-, during, and posthospital visits for the same episode of febrile illness. Only four OP cases had some kind of medical insurance.Conclusion:High expenditure on both OP and indoor patients calls for appropriate policy for provision of financial protection while seeking health-care services. Health facilities should be tuned to do cost analysis enabling comparison among health facilities.

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Cost of Treatment of Febrile Acute Respiratory Infection (FARI) Among Under-Five Children Attending Health Facilities of Ballabgarh, Haryana

Abstract: 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.

Cited by 3 publications

References 15 publications

Assessment of hospitalization costs and its determinants in infants with clinical severe infection at a public tertiary hospital in Nepal

Assessment of hospitalization costs and its determinants in infants with clinical severe infection at a public tertiary hospital in Nepal

Out-of-pocket expenditure and its predictors for illness of under-five children: A cross-sectional study in urban slums of Eastern India

Costing of febrile illness among under five children, a study in a tertiary care teaching hospital in Odisha, India

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