Sarker Abdur Razzaque, Sultana Marufa, Mahumud Rashidul Alam, Ali Nausad, Huda Tanvir M, Salim Uzzaman M, Haider Sabbir, Rahman Hafizur, Islam Ziaul, Khan Jahangir A M, Van Der Meer Robert, Morton Alec
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
University of Strathclyde, Glasgow, UK.
Glob Health Res Policy. 2018 Jan 5;3:1. doi: 10.1186/s41256-017-0056-5. eCollection 2018.
Diarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality worldwide. Although the burden of the diarrheal diseases is much lower in developed countries, it is a significant public health problem in low and middle-income countries like Bangladesh. Though diarrhea is preventable and managed with low-cost interventions, it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those patients. The aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal illness.
This study was conducted in six randomly selected district hospitals from six divisions (larger administrative units) in Bangladesh. The study was performed from the societal perspective which means all types of costs were identified, measured and valued no matter who incurred them. Cost analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal diseases. The study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires, observation checklists, analysis of hospital database, telephone interviews and compilation of service statistics.
The average total societal cost of illness per episode was BDT 5274.02 (US $ 67.18) whereas the average inpatient and outpatient costs were BDT 8675.09 (US $ 110.51) and BDT 1853.96 (US $ 23.62) respectively. The cost burden was significantly highest for poorest households, 21.45% of household income, compared to 4.21% of the richest quintile.
Diarrheal diseases continue to be an overwhelming problem in Bangladesh. The economic impact of any public health interventions (either preventive or promotive) that can reduce the prevalence of diarrheal diseases can be estimated from the data generated from this study.
腹泻病是对人类健康的重大威胁，仍是全球发病和死亡的主要原因。尽管腹泻病在发达国家的负担要低得多，但在孟加拉国等低收入和中等收入国家，它却是一个重大的公共卫生问题。虽然腹泻可以通过低成本干预措施预防和控制，但根据在孟加拉国公立医院就诊的患者情况，腹泻仍是发病的主要原因，这表明治疗这些患者消耗了大量资源。本研究的目的是获取腹泻病住院和门诊治疗费用，并衡量与腹泻病相关的成本负担和应对机制。
本研究在孟加拉国六个分区（较大的行政单位）随机选择的六家区级医院进行。该研究从社会角度进行，这意味着无论费用由谁承担，所有类型的成本都要识别、测量和估值。成本分析采用世界卫生组织提出的估计腹泻病经济负担的指南进行估算。该研究采用定量技术收集家庭和医院层面的数据，包括结构化和半结构化问卷、观察清单、医院数据库分析、电话访谈和服务统计汇编。
每例疾病的平均社会总成本为5274.02孟加拉塔卡（67.18美元），而平均住院和门诊费用分别为8675.09孟加拉塔卡（110.51美元）和1853.96孟加拉塔卡（23.62美元）。最贫困家庭的成本负担最高，占家庭收入的21.45%，而最富裕五分之一家庭为4.21%。
腹泻病在孟加拉国仍然是一个极其严重的问题。从本研究生成的数据中，可以估计任何能够降低腹泻病患病率的公共卫生干预措施（无论是预防性还是促进性）的经济影响。
