Cost of Treatment of Febrile Acute Respiratory Infection (FARI) Among Under-Five Children Attending Health Facilities of Ballabgarh, Haryana.

Abstract

To estimate the expenditure incurred towards treatment of an episode of respiratory infection among under-fives in outpatient and inpatient departments of primary and secondary level health facilities. During March 2011 - September 2012, under-five children presenting with febrile acute respiratory infection (FARI) in the outpatient (OPD) and inpatient (IPD) departments of public and private health facilities of Ballabgarh, Haryana were enrolled in the study. Children who were free from co-morbidities and whose contact number or proper address were available, were enrolled and followed up over telephone or by house visits till recovery. Information was collected on expenditure incurred towards treatment of FARI. Work loss of each day was valued as per capita national income per day. Cost of service in public facilities were supplemented by WHO-CHOICE estimates. The cost of respiratory episode in different settings are expressed in median and inter quartile range (IQR). One hundred fourteen children from OPD and 75 from IPD were enrolled and followed up till recovery. Among eligible children 40% and 20% in OPD and IPD were excluded respectively as they could not provide address or contact number. The median costs of an episode treated in OPD and IPD were INR 447(IQR: INR 294-669) and INR 7506.06 (IQR: INR 3765-10,406) respectively. Respiratory infections are responsible for substantial economic burden, especially with huge proportion of out-of-pocket expenditure. Total cost of a respiratory episode that required hospitalization was 1.5 times the per capita monthly income of an Indian.