Costing of severe pneumonia in hospitalized infants and children aged 2-36 months, at a secondary and tertiary level hospital of a not-for-profit organization

To determine health care provider cost and household cost of the treatment of severe pneumonia in infants and young children admitted to secondary and tertiary level health care facilities. The study was done in a private, not-for-profit medical college hospital, in Vellore, India, in mid-2008. Chil...

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Bibliographic Details
Published in:	Tropical medicine & international health Vol. 14; no. 10; pp. 1315 - 1322
Main Authors:	Madsen, Helle Ostergaard, Hanehøj, Malin, Das, Ashima Rani, Moses, Prabhakar D, Rose, Winsley, Puliyel, Mammen, Konradsen, Flemming, John, K.R, Bose, Anuradha
Format:	Journal Article
Language:	English
Published:	Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01-10-2009 Blackwell Publishing Ltd Blackwell
Subjects:	bebes Biological and medical sciences Child, Preschool childhood Childrens health Cost of Illness Cost-Benefit Analysis costes costing coûts enfance Female General aspects Health Care Costs Health care expenditures Hospitalization Hospitalization - economics Hospitalization - statistics & numerical data Hospitals, Public - economics Humans India Infant infants Male Medical sciences Medical treatment neumonía severa niveau secondaire niñez nourrissons Pneumology Pneumonia Pneumonia - economics Pneumonia - mortality pneumonie sévère Respiratory system : syndromes and miscellaneous diseases secondary level segundo y tercer nivel severe pneumonia tertiaire tertiary level India Vellore India Human severe pneumonia Lung disease Pneumonia infants secondary level childhood Respiratory disease costing Infant Hospitalization Tropical medicine tertiary level Hospital Child
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Summary:	To determine health care provider cost and household cost of the treatment of severe pneumonia in infants and young children admitted to secondary and tertiary level health care facilities. The study was done in a private, not-for-profit medical college hospital, in Vellore, India, in mid-2008. Children aged 2-36 months admitted with severe pneumonia with no underlying chronic disease were included in the study. The relatives were interviewed daily on matters relating to patients' view point of the costs. These were direct medical costs, direct non-medical costs which comprised travel, accommodation and special food during the period of illness, and indirect costs of productivity loss for family members. Patient specific resource consumption and related charges were recorded from charts, nursing records, pharmacy lists and hospital bills, and the providers view point of the costs was estimated. Unit cost estimates for bed days, treatment and investigation inputs were calculated. Total cost to health care provider for one episode of hospitalized childhood pneumonia treated at secondary level was US$ 83.89 (INR 3524) and US$ 146.59 (INR 6158) at tertiary level. At both levels the greatest single cost was the hospital stay itself, comprising 74% and 56% of the total cost, respectively. Diagnostic investigations were a large expense and supportive treatment with nebulization and oxygen therapy added to the costs. Mean household expenditure on secondary level was US$ 41.35 (INR 1737) and at tertiary level was US$ 134.62 (INR 5655), the largest single expense being medicines in the former and the hospitalization in the latter. (one US$=INR 42.1 at time of study) A considerable cost difference exists between secondary and tertiary level treatment. Admission at lowest possible treatment level for appropriate patients could decrease the costs borne by the provider and the patient.
Bibliography:	http://dx.doi.org/10.1111/j.1365-3156.2009.02374.x ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1360-2276 1365-3156
DOI:	10.1111/j.1365-3156.2009.02374.x