Abstract
Introduction: Neurological disorders, structural or functional, are prevalent all over the world and are accompanied by physical and social morbidity. In this study, we aimed to calculate the cost of investigating neurological disorders and compare the costs incurred in a government hospital with that in a private hospital.Materials and Methods: This study was conducted at the Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan. One hundred patients were enrolled in the study; 10 each investigated for epilepsy, cerebrovascular accidents (CVAs), headache, neuropathy, myopathy, cranial nerve palsies, movement disorders, demyelinating diseases, central nervous system (CNS) infections, and dementia. Receipts and records in the patients’ medical history were used for the calculation of the cost of procedures, which was then compared with the costs of these investigations in a private hospital. A bottom-up costing approach was taken with individual costs being estimated and then being grouped to calculate the overall economic burden of the disorders. Data were analyzed using IBM SPSS version 23.0. One-way analysis of variance (ANOVA) was done to compare the mean cost (taken by the patient, covered by the government, total cost in the government hospital, and total cost in the private hospital) across diseases in government and private hospitals separately. Pearson correlation and scatter plot were also done to study the cost in private and public hospitals. p-values less than 0.05 were considered statistically significant. The margin of error in the study was 5%.Results: The mean age was 38.2 ± 20.5 years. Some 51% data were received from female samples. The mean income of samples was 13863.6 ± 9715.9 Pakistani Rupees (PKR) or 78.38 ± 58.29 United States Dollars (USD). The mean cost covered by government hospitals was 8866.0 ± 5071.0 PKR (53.19 ± 30.42 USD) per patient, whereas in government hospitals patients were charged on average 2662.9 ± 3774.7 PKR (16 ± 22.65 USD), while in private hospitals patients paid on average 29041.3 ± 12992.6 PKR (174.21 ± 78 USD).Conclusion: The costs of investigations in private hospitals were approximately three times the costs in government hospitals. The maximum cost was generated by patients being investigated for demyelinating disorders. Investigations conducted in government-run hospitals are more cost effective and these institutions should receive increased funding to cater to the maximum number of patients.
Highlights
Neurological disorders, structural or functional, are prevalent all over the world and are accompanied by physical and social morbidity
One hundred patients were enrolled in the study; 10 each investigated for epilepsy, cerebrovascular accidents (CVAs), headache, neuropathy, myopathy, cranial nerve palsies, movement disorders, demyelinating diseases, central nervous system (CNS) infections, and dementia
The mean cost covered by government hospitals was 8866.0 ± 5071.0 Pakistani Rupees (PKR) (53.19 ± 30.42 United States Dollars (USD)) per patient, whereas in government hospitals patients were charged on average 2662.9 ± 3774.7 PKR (16 ± 22.65 USD), while in private hospitals patients paid on average 29041.3 ± 12992.6 PKR (174.21 ± 78 USD)
Summary
Neurological disorders, structural or functional, are prevalent all over the world and are accompanied by physical and social morbidity. We aimed to calculate the cost of investigating neurological disorders and compare the costs incurred in a government hospital with that in a private hospital. Out of all the chronic diseases that burden the world, neurological or mental illnesses are the most prevalent [1]. The term ‘disorders of the brain’ is used to describe mental and neurological illnesses. Together, these make up approximately 13% of all diseases experienced by patients worldwide. Measurements of the all cause morbidity burden, calculated by disability-adjusted life years (DALYs), of neurological disorders in the European Union showed that disorders of the brain were the largest cause of morbidity and pose the greatest economic challenge for European healthcare [4]. The Global Burden of Disease studies that cover all disease groups and injury categories, demonstrate that, in the future, increasingly higher proportions of the global burden of disease will be attributed to brain disorders [5]
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