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. 2018 Jun;2(2):179-190.
doi: 10.1007/s41669-017-0041-4.

Cost of Intensive Care Treatment for Liver Disorders at Tertiary Care Level in India

Shankar Prinja  1 , Pankaj Bahuguna  2 , Ajay Duseja  3 , Manmeet Kaur  2 , Yogesh Kumar Chawla  3
Affiliations

Cost of Intensive Care Treatment for Liver Disorders at Tertiary Care Level in India

Shankar Prinja et al. Pharmacoecon Open. 2018 Jun.

Abstract

Background: Liver diseases contribute significantly to the health and economic burden globally. We undertook this study to assess the health system costs, out-of-pocket (OOP) expenditure and extent of financial risk protection associated with treatment of liver disorders in a tertiary care public sector hospital in India.

Methodology: The present study was undertaken in an intensive care unit (ICU) of a tertiary care hospital in North India. It comprised an ICU and an HDU (high dependency unit). Bottom-up micro-costing was undertaken to assess the health system costs. Data on OOP expenditure and indirect costs were collected for 150 liver disorder patients admitted to the ICU or HDU from December 2013 to October 2014. Per-patient and per-bed-day costs of treatment were estimated from both health system and patient perspectives. Financial risk protection was assessed by computing prevalence of catastrophic health expenditure as a result of OOP expenditure.

Results: In 2013-2014, health system costs per patient treated in the ICU and HDU were US$2728 [Indian National Rupee (INR) 1,63,664] and US$1966 (INR 1,17,985), respectively. The mean OOP expenditures for treatment in the ICU and HDU were US$2372 (INR 1,42,297) and US$1752 (INR 1,05,093), respectively. Indirect costs of hospitalization in ICU and HDU patients were US$166 (INR 9952) and US$182 (INR 10,903), respectively.

Conclusion: Treatment of chronic liver disorders poses an economic challenge for both the health system and patients. There is a need to focus on prevention of liver disorders, and finding ways to treat patients without exposing their households to the catastrophic effect of OOP expenditure.

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Conflict of interest statement

Funding

The study was funded by the intramural Research Grant of Post Graduate Institute of Medical Education and Research, Chandigarh, India (http://pgimer.edu.in/PGIMER_PORTAL/PGIMERPORTAL/home.jsp).

Ethical approval

The study was approved by the Institute Ethics Committee of the Post Graduate Institute of Medical Education and Research, Chandigarh, India. Informed consent was taken from concerned persons at the time of data collection.

Conflict of interest

Shankar Prinja, Pankaj Bahuguna, Ajay Duseja, Manmeet Kaur and Yogesh K. Chawla declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Determinants (%) of out-of-pocket expenditure for treatment of liver disorders in an intensive care unit in India. HDU high dependency unit, ICU intensive care unit
Fig. 2
Fig. 2
Coping mechanisms (%) for out-of-pocket expenditure for treatment of liver disorders in an intensive care unit in India. HDU high dependency unit, ICU intensive care unit
See this image and copyright information in PMC

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