Operational cost for management of leprosy-related complicated ulcer in charitable hospitals

Abstract

Leprosy causes skin lesion and nerve damage which can ultimately progress to secondary impairments of the eyes, hands and feet. The most important aspect of nerve damage is the sensory dysfunction which can lead to insensitivity and a predisposition to the development of ulcers. Plantar ulceration is the single most common cause of morbidity among leprosy-affected people. Ulcers also pose a significant problem to health services as the treatment and rehabilitation of patients with ulcers is extremely demanding on the health care budget. Standard wound therapy for complicated ulcers extends, on average, through 30 days of conventional treatment. Within that time most will heal given adequate treatment. The paucity of data on the operating costs of ulcer management in in-patient settings also applies to the unit costs of various services provided in ulcer management for leprosy patients. Charitable hospitals have played a vital role all through the history of leprosy control in India. One of the major tasks undertaken by them is running referral care centres to manage simple and complicated ulcers. Even in the post-integration phase, specialised services offered by such hospitals remain relevant. Given the prevailing fund constraints, therefore, obtaining financial estimates for ulcer care management would be useful. Such estimates would yield more precise information for decision-makers who could then allocate financial resources efficiently. The main objective of our study was to estimate the operational costs involved in the in-patient treatment of leprosy-related complicated ulcers.