Sharma Anuradha, Prinja Shankar, Thakur Ravinder, Gupta Dharna, Kaur Rajwinder, Sharma Sameer, Munjal Sanjay, Panda Naresh
Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1716-1723. doi: 10.1007/s12070-023-04389-7. Epub 2023 Nov 28.
Making evidence-based policy decisions is challenging when there is a lack of information, especially when deciding provider payment rates for publicly funded health insurance plans. Therefore, the goal of this study was to estimate the cost of a cochlear implant operation in a tertiary care setting in India. We also looked at the patients' out-of-pocket (OOP) expenses for the cochlear implant surgery. From the perspectives of the patients and the healthcare systems, we assessed the financial costs of the cochlear implantation procedure. A bottom-up pricing model was used to assess the cost that the healthcare system would bear for a cochlear implant procedure. Information on all the resources (both capital and ongoing) required to offer cochlear implantation services for hearing loss was gathered over the course of a year. 120 individuals with hearing loss who had cochlear implantation surgery disclosed their out-of-pocket (OOP) costs, which included both direct medical and non-medical expenses. All costs for the budgetary year 2018-2019 were anticipated. The unit health system spent ₹ 151($2), ₹ 578($7.34) and ₹ 37,449($478) on ear exams, audiological evaluations, and cochlear implant surgeries, respectively. Per bed-day in the otolaryngology ward, hospitalization cost ₹ 202($2.6), or ₹ 1211($15.5). The estimated average out-of-pocket cost for a cochlear implant operation was ₹ 682,230($8710). Our research can be used to establish package rates for publicly funded insurance plans in India, plan the growth of public sector hearing care services, and do cost-effectiveness assessments on various hearing care models.
The online version contains supplementary material available at 10.1007/s12070-023-04389-7.
在缺乏信息时，做出基于证据的政策决策具有挑战性，尤其是在为公共资助的医疗保险计划确定医疗服务提供者支付费率时。因此，本研究的目的是估计印度三级医疗环境中人工耳蜗植入手术的成本。我们还研究了患者在人工耳蜗植入手术中的自付费用。从患者和医疗系统的角度，我们评估了人工耳蜗植入手术的财务成本。采用自下而上的定价模型来评估医疗系统为人工耳蜗植入手术承担的成本。在一年的时间里收集了提供听力损失人工耳蜗植入服务所需的所有资源（包括资本和经常性资源）的信息。120名接受人工耳蜗植入手术的听力损失患者披露了他们的自付费用，其中包括直接医疗费用和非医疗费用。预计了2018 - 2019预算年度的所有成本。单位医疗系统在耳部检查、听力评估和人工耳蜗植入手术上分别花费了151卢比（2美元）、578卢比（7.34美元）和37449卢比（478美元）。在耳鼻喉科病房，每床日住院费用为202卢比（2.6美元），即1211卢比（15.5美元）。人工耳蜗植入手术的估计平均自付费用为682230卢比（8710美元）。我们的研究可用于确定印度公共资助保险计划的套餐费率、规划公共部门听力保健服务的发展以及对各种听力保健模式进行成本效益评估。
在线版本包含可在10.1007/s12070 - 023 - 04389 - 7获取的补充材料。
