Economic costs of hospitalized diarrheal disease in Bangladesh: a societal perspective

Abstract

BackgroundDiarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality worldwide. Although the burden of the diarrheal diseases is much lower in developed countries, it is a significant public health problem in low and middle-income countries like Bangladesh. Though diarrhea is preventable and managed with low-cost interventions, it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those patients. The aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal illness.MethodsThis study was conducted in six randomly selected district hospitals from six divisions (larger administrative units) in Bangladesh. The study was performed from the societal perspective which means all types of costs were identified, measured and valued no matter who incurred them. Cost analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal diseases. The study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires, observation checklists, analysis of hospital database, telephone interviews and compilation of service statistics.ResultsThe average total societal cost of illness per episode was BDT 5274.02 (US $ 67.18) whereas the average inpatient and outpatient costs were BDT 8675.09 (US $ 110.51) and BDT 1853.96 (US $ 23.62) respectively. The cost burden was significantly highest for poorest households, 21.45% of household income, compared to 4.21% of the richest quintile.ConclusionsDiarrheal diseases continue to be an overwhelming problem in Bangladesh. The economic impact of any public health interventions (either preventive or promotive) that can reduce the prevalence of diarrheal diseases can be estimated from the data generated from this study.

Cost of illness for childhood diarrhea in low- and middle-income countries: a systematic review of evidence and modelled estimates

“…Studies identified for quantitative analysis in the systematic review (N = 25) represented six low-income countries (LIC) [16,[28][29][30][31][32], nine lower-middle-income countries (LMIC) [18,19,30,[33][34][35][36][37][38][39][40][41][42][43][44], and five uppermiddle-income countries (UMIC) [13,17,[45][46][47], as classified by the World Bank's income groups in 2018 [25]. While most studies reported using societal perspective (22/25, 88%) in measuring cost [13, 17-19, 29-32, 34-37, 39, 41-49], we observed a wide variation in use of term societal perspective across those studies.…”

“…For Bangladesh, the reported estimates of total direct cost across (not distinguished by Inpatient or Outpatient) three studies were $1.70 [29], $3.49 [43], and $22.69 [36]. The higher estimates were for a tertiary-level hospital, whereas the lower estimates were from a rural setting covering costs of primary care.…”

Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh

“…The disease can be prevented and managed at household level with low cost oral rehydration therapy (ORT), however, the patient frequently visits the health facilities which imposes a substantial economic burden for the affected households [15,16]. Recent study showed that by controlling diarrheal diseases households could save approximately US$ 136.03 million in Bangladesh which usually exhausted for receiving treatment [17].…”

Inequality in Health Services for Internal Migrants in China: A National Cross-Sectional Study on the Role of Fund Location of Social Health Insurance

“…Our data show that the overall level of health services used by the internal migrants is low: only about half of the internal migrants visited a medical doctor when needed, compared with a national average of 84.5% (in 2013) [ 69 ]. The low coverage (31.28%) of health records in this population is particularly concerning because it is unlikely that these migrants are able to obtain access to the essential public health services (such as case management of chronic conditions) outside of one’s residential location [ 69 , 70 , 71 ]. On average, almost 70% of the entire population in China had been covered by a health record in 2013 [ 69 ].…”