PGI9 - Cost of illness (COI) associated with gastrointestinal and liver disease: A study conducted at an indian teritary care hospital

Abstract

To study cost of illness (COI) by calculating direct and indirect cost in the patients with gastrointestinal and liver disease from societal perspective. Study was conducted in general medicine ward of government tertiary care hospital, north India by including inpatients diagnosed with gastrointestinal and liver disorders. In terms of time perspective prevalence approach was used to study COI. Direct cost was estimated using admission fee, cost of bed, diet charge, cost of medications and diagnostic tests/surgical procedures. Indirect cost was estimated using loss of wages, travelling cost, food cost, and cost of bed for attendant/s of patient due to hospital stay. Estimated costs were converted to purchasing power parity dolor (PPP$) for cross country comparison. To estimate the productivity loss, human capital approach was used with assumption that income reflects productivity. A total 202 patients (83% males) were included in the study. Most prevalent disorder includes alcoholic liver disease (32.5%) and most common class of drug prescribed was proton pump inhibitor (94%). Majority of the patients (53%) with these diseases has hospital stay of 1 to 7 days. The total direct costs and indirect cost of disease for study patients were PPP$ 23518 and PPP$ 30187 respectively. Direct and indirect cost of disease for each patient was PPP$ 231 and PPP$ 277 respectively. The cost of medication (17.8%) and loss of wages (43.9%) contributes major component of direct and indirect cost respectively. Total cost for males (PPP$ 276.0±145) is significantly higher (P <0.05) than the total cost for females (PPP$ 232.6±146.6). Mean direct and indirect costs incurred by female patients were significant less than that of male patients. Cost of medication and loss of wages of patients contributes major component of COI. Increasing the number of day of hospital stay leads to higher cost of burden.