Out-of-Pocket Expenditure and Opportunity Cost of Leptospirosis Patients at a Tertiary Care Hospital of Gujarat, India.

INTRODUCTION

The study investigates the cost incurred by leptospirosis patients as either out-of-pocket expenditure (OOPE) or opportunity cost (OC) and recommends accordingly for the national program on leptospirosis in India.

OBJECTIVES

The objective of this study is to determine leptospirosis-related OOPE and OC at a government tertiary care hospital and to disaggregate the total OOPE into contributing cost domains.

MATERIALS AND METHODS

The OOPE data were collected by the personal interview of confirmed leptospirosis cases who took complete treatment at the hospital in year 2009 using a prestructured questionnaire. The patients were interviewed daily until discharge to know daily OOPE.

RESULTS

The mean OOPE per patient was Rs. 2157/-, Median: Rs. 1880/-, 25-75 percentile: Rs. 1446 - Rs 2587.5). The lowest quintile for OOPE was Rs. 1330/- and the highest quintile was Rs. 2874/-. Loss of daily wages was 68% (Rs. 1458.9/-) of the total OOPE. Other major expenditure included cost of drugs Rs. 308.8/- (14%), expenditure on food Rs. 173/- (8%), and travelling expenses Rs. 204.4/- (9%).

CONCLUSIONS

Rs. 2157/- is significant OOPE, and hence, important factor in understanding health-seeking behavior and compliance of leptospirosis patients. The OC (loss of daily wages) amounts to 68% of total OOPE which has to addressed by the government to realize universal health coverage.