Cost Burden of Dengue Fever in a Rural Ramanagara District of Karnataka State

Abstract

ABSTRACTIntroductionDengue fever is an arboviral disease caused by dengue virus, which is a single-stranded RNA virus and belongs to family Flaviviridae. Dengue fever (DF) has emerged as a global public health problem in recent years. The problem has become hyperendemic in many urban, peri-urban and rural areas, with frequent epidemics South-East Asia is one of the regions with highest risk of DF and accounts for 52% of the worldwide risk. In India, according to World Health Organization, 70.8% of the total health care expenditure was out-of-pocket in 2010. According to the World Bank, the percentage of out-of-pocket expenditure is as high as 86.4%. Dengue fever causes a significant economic and social burden on the population of endemic areas. This study was conducted with the objective to estimate the direct and indirect cost expenditure on families of dengue affected members and to assess the financial coping mechanisms of the families.Materials and methodsConfirmed cases of DF with either NS-1 positive or IgM positive or positive for both and willing to participate in the study formed the sample. After taking informed consent, study subjects were interviewed using a pretested, semi-structured questionnaire. Questionnaire included demo- graphic profile and questions related to their financial coping mechanisms. Information on the laboratory bill, hospital bill, and pharmacy bill was collected from the hospital records on the day of patient's discharge. Indirect cost, such as travel expenses, food, and beverage expenses were collected from the family members of dengue patients. Necessary permission was taken from the hospital and RajaRajeswari Medical College & Hospital, Bengaluru, Karnataka, India. Data were collected and compiled in the MS excel sheet and were analyzed using Statistical Package for the Social Sciences version 20.0. Descriptive statistics-qualitative variables were presented as frequencies and percentages, continuous variables, such as hospital stay and cost are expressed in terms of mean and standard deviation.ResultsAverage direct cost per household for treatment of dengue was 5185.395 INR. Average out-of-pocket expenditure per household for treatment of dengue was 6190 INR. Most of the households used savings as a mechanism to cope up with the increased expenditure due to dengue. About 77.6% of the households diverted their savings to pay for the treatment of dengue, 18.4% of households borrowed money from friends and relatives to pay the hospital bills, and the remaining 3% respondents used their health insurance as a financial coping mechanism to get the treatment for dengue.ConclusionThere is a substantial financial loss to the Indian families of which a significant proportion lies below the poverty line. Government is the only agency working for the prevention of this kind of vector-borne disease. Public awareness in the community about the treatment of dengue is very scant. People use their savings which is the major method to cope up with expenditure due to DF. Significant proportion of the population uses the incurred borrowing as a method to pay for the treatment of dengue, which is a matter of concern.How to cite this articleKumar N, Shyam AC, Vidya. Cost Burden of Dengue Fever in a Rural Ramanagara District of Karnataka State. J Med Sci 2016;2(4):59-61.