Cost analysis of childhood diarrhoeal inpatients : a case study of Narayanganj District Hospital Bangladesh

Abstract

Diarrhoea, a water-borne communicable disease continues to be a major public health problem of greater concern in Bangladesh due to which disease alone approximately 260,000 children die every year. Information on the costs incurred by the providers and consumers for the management of diarrhoeal cases is vital in understanding and improving the effectiveness of the programme. Costs incurred by the people in receiving the treatment for diarrhoeal disease at Narayanganj District Hospital in Bangladesh were estimated using a structured questionnarie. A total of 20 cases from urban and 80 cases from rural areas were selected and interviewed for this purpose. The different cost components identified from the patient perspective include registration fee, bed charges, medical expenses, food cost for the patients and parents, transport cost and opportunity cost due to work loss. The cost incurred by the people from rural areas in receiving the treatment for diarrhoeal disease was estimated to the Taka 1,989.59 which was significantly (t=3.39; p=less than 0.05) higher than that incurred by the urban patients (Taka 1,465.40). The major cost component for the rural patient was found to be the opportunity cost due to wage lost (28.63%) while it was the food cost (22.29%) for the urban patients. The perceived satisfaction among the respondents on the health services was also analyzed by using structured questionnaire. Rating scale was give and, based on this, an index was derived to compare across service points between rural and urban. The level of satisfaction expressed by the rural people was significantly higher at District Hospital (p = less than 0.05) when compared with the Health complexes and Health centres. Main causes of non-using local health facilities were reported to be low medical care, minimum and inadequate investigation facilities as well as doctors' absenteeism Improving health facilities at peripheral level is worth considering as higher cost was incurred by the patients who were forced to seek care at District hospitals. This was evident from the present study on the patients' cost in receiving health care for diarrhoeal management. This will benefit the rural community by the way of reducing the cost while receiving care at their convenient service points.