Okanurak K, Sornmani S, Indaratna K
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1997 Dec;28(4):711-7.
The economic burden of DHF patients and of the Thai government in providing treatment and prevention and control of dengue hemorrhagic fever were assessed. Patient burden was reported by caretakers who stayed with the patients when they were admitted to three hospitals: Children's Hospital in Bangkok; Suphan Buri Provincial Hospital and Don Chedi Community Hospital, Don Chedi District in Suphan Buri Province. The hospital costs--medicine and laboratory costs--were collected from the treatment forms and the routine service cost was estimated by the staff of the hospitals. Cost of prevention and control were compiled from the budget report of Departments of the Ministry of Public Health and the Ministry of Interior. Based on 184 DHF patients admitted at the three hospitals, the direct patient costs--treatment cost and the costs of travel, food and lodging--was 66.99 US$ and 61.02 US$ per patient for one episode of DHF in Bangkok and Suphan Buri, respectively. The total patient costs--direct patient costs and opportunity costs were 118.29 US$ for a child patient and 161.49 US$ for an adult patient in Bangkok, 102.82 US$ for a child patient and 138.02 US$ for an adult patient in Suphan Buri. The net hospital cost in providing treatment for each DHF patient was 54.6 US$ and 38.65 US$ in Bangkok and Suphan Buri, respectively. The total cost of prevention and control of DHF in Thailand from government agencies in 1994 was 4.8724 million US$. Based on these findings, the whole expenditure of Thailand for DHF in 1994, would be at least 12.596 million US$, of which 54.8% was from the government budget, the rest, 45.2%, was the expenses paid by 51,688 patients and their families. The study concluded that in recording the economic-loss of DHF both the expenditures of the government and also the patient costs--direct and indirect--should be taken into account.
评估了登革出血热患者的经济负担以及泰国政府在提供登革出血热治疗与防控方面的经济负担。患者负担由在患者入住三家医院时陪伴他们的看护人报告，这三家医院分别是：曼谷儿童医院；素攀武里府医院以及素攀武里府敦猜地区的敦猜社区医院。医院成本（药品和实验室成本）从治疗表格中收集，常规服务成本由医院工作人员估算。防控成本根据公共卫生部和内政部各部门的预算报告汇编而成。基于三家医院收治的184例登革出血热患者，在曼谷和素攀武里，每例登革出血热发作的直接患者成本（治疗成本以及交通、食品和住宿成本）分别为66.99美元和61.02美元。患者总成本（直接患者成本和机会成本）在曼谷，儿童患者为118.29美元，成人患者为161.49美元；在素攀武里，儿童患者为102.82美元，成人患者为138.02美元。曼谷和素攀武里为每位登革出血热患者提供治疗的净医院成本分别为54.6美元和38.65美元。1994年泰国政府机构用于登革出血热防控的总成本为487.24万美元。基于这些发现，1994年泰国用于登革出血热的总支出至少为1259.6万美元，其中54.8%来自政府预算，其余45.2%是51688名患者及其家庭支付的费用。该研究得出结论，在记录登革出血热的经济损失时，应同时考虑政府支出以及患者成本（直接和间接成本）。
