Are we contented with achieving universal health coverage in treating dengue patients in Sri Lanka?

Abstract

Background: The preventive and curative services for dengue illness cause a significant financial burden on the state health sector. Household costs and out-of-pocket expenditure (OOPE) too are important cost components embedded with dengue illness. The objective was to estimate the household costs and out-of-pocket expenses incurred due to dengue infection among adults who received institutional care in Colombo district, Sri Lanka.Methods: A longitudinal study was conducted from July to December 2018. Fifty patients recruited from dengue fever (DF) and dengue hemorrhagic fever (DHF) categories. Adults residing in the Colombo district for more than six months prior to dengue illness were recruited based on systematic sampling. Data was collected via an interviewer-administered questionnaire on the day of discharge from the hospital and followed up for two weeks. Unit cost per patient was calculated. Household costs were calculated for 3 phases: ambulatory, during, and post-hospitalization. These components were described using mean, median, standard deviation and inter-quartile range, and OOPE.Results: The median age in the DF group was 38.5 years and in the DHF group was 28.5 years. The average household cost was US$ 127.69 (SD=93.32) and US$ 134.71 (SD=94.31) for DF and DHF patients respectively. Among DF patients 98.03% were borne using OOPE and among DHF patients it was 95.57%.Conclusions: If an adult member is hospitalized with dengue infection the OOPE is high, which is nearly 25% of a family’s monthly income. Strengthening dengue control programme is the key to universal health coverage (UHC).