Viral R Bajwala1, Denny John2,3, T Daniel Rajasekar4, Manoj V Murhekar4. 1. Department of Health and Hospital, Surat Municipal Corporation, Gujarat, India. 2. Campbell Collaboration, New Delhi, India. 3. ICMR-National Institute of Medical Statistics, New Delhi, India. 4. National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India.
Abstract
BACKGROUND: Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. METHODS: We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. RESULTS: Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. CONCLUSIONS: A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.
BACKGROUND: Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. METHODS: We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. RESULTS: Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. CONCLUSIONS: A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.