Out of Pocket Expenditure incurred by COVID Patients during second wave of COVID Pandemic in North coastal Andhra Pradesh

Abstract

Background: COVID-19 causes various complications in patients, requiring hospitalization and treatment in Intensive Care Units (ICUs), resulting in high medical expenditure. At least 80 percent of COVID-19 patients are being treated in government hospitals across the country. The present study focuses on the expenditure of hospitalized patients, patients admitted to COVID care centers, and patients treated in home isolation. Objective: To measure the Out-of-Pocket Expenditure (OOPE) spent by hospitalized patients admitted to COVID care centers, and patients treated in home isolation due to COVID. Methodology :An observational cross-sectional study was conducted in Visakhapatnam among 180 individuals pertaining to 10 Primary Health Centers who tested positive for COVID infection in the second wave (after April 2021) through Reverse Transcription Polymerase Chain Reaction or TrueNat. An interview using a structured questionnaire consisting of socio-demographic details, expenditure details, insurance claims, and government schemes availed by COVID patients during the treatment was conducted. Results: The Median OOPE incurred by the patient towards hospital charges was INR 5000 [Interquartile Range (IQR) 0;88000]. About 109 (60%) of the study subjects were hospitalized, of which 35.7% sought care from government hospital. In the study, only 59 (32.7%) patients had health insurance, which was not useful to most of them during COVID. About 73.3% had an Arogyasri card/Employees Health Scheme (EHS) card, but only 22.7% could use it. Conclusion: The study shows that health insurance has not recovered the expenditure, suggesting that insurer cost-sharing waivers may not have covered all hospitalization-related care.