Cost of illness for outpatients attending public and private hospitals in Bangladesh
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: A central aim of Universal Health Coverage (UHC) is protection for all against the cost of illness. In a low income country like Bangladesh the cost burden of health care in tertiary facilities is likely to be significant for most citizens. This cost of an episode of illness is a relatively unexplored policy issue in Bangladesh. The objective of this study was to estimate an outpatient’s total cost of illness as result of treatment in private and public hospitals in Sylhet, Bangladesh.
Methods: The study used face to face interviews at three hospitals (one public and two private) to elicit cost data
from presenting outpatients. Other socio-economic and demographic data was also collected. A sample of 252 outpatients were randomly selected and interviewed. The total cost of outpatients comprises direct medical costs, non-medical costs and the indirect costs of patients and caregivers. Indirect costs comprise travel and waiting times and income losses associated with treatment.
Results: The costs of illness are significant for many of Bangladesh citizens. The direct costs are relatively minor
compared to the large indirect cost burden that illness places on households. These indirect costs are mainly the
result of time off work and foregone wages. Private hospital patients have higher average direct costs than public
hospital patients. However, average indirect costs are higher for public hospital patients than private hospital
patients by a factor of almost two. Total costs of outpatients are higher in public hospitals compared to private
hospitals regardless of patient’s income, gender, age or illness.
Conclusion: Overall, public hospital patients, who tend to be the poorest, bear a larger economic burden of illness
and treatment than relatively wealthier private hospital patients. The large economic impacts of illness need a public
policy response which at a minimum should include a national health insurance scheme as a matter of urgency.
Description
CITATION: Pavel, M. D. S., Chakrabarty, S. & Gow, J. 2016. Cost of illness for outpatients attending public and private hospitals in Bangladesh. International Journal for Equity in Health, 15:167, doi:10.1186/s12939-016-0458-x.
The original publication is available at https://equityhealthj.biomedcentral.com
The original publication is available at https://equityhealthj.biomedcentral.com
Keywords
Outpatients -- Bangladesh, Ambulatory medical care -- Cost of operation -- Bangladesh, Public health -- Bangladesh, Health facilities, Proprietary -- Bangladesh
Citation
Pavel, M. D. S., Chakrabarty, S. & Gow, J. 2016. Cost of illness for outpatients attending public and private hospitals in Bangladesh. International Journal for Equity in Health, 15:167, doi:10.1186/s12939-016-0458-x