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ORIGINAL ARTICLE
Year : 2020  |  Volume : 64  |  Issue : 3  |  Page : 252-257

Out-of-pocket health expenditure on diarrheal illness among under-five children in a teaching hospital ins Odisha, India


1 Associate Professor, Department of Public Health, School of Public Health, KIIT Deemed to be University, Bhubaneswar, Odisha, India
2 Associate Professor, Department of Paediatrics, Kalinga Institute of Medical Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
3 Faculty Associate, Department of Public Health, School of Public Health, KIIT DU, Bhubaneswar, Odisha, India
4 Director, Department of Public Health, School of Public Health, KIIT DU, Bhubaneswar, Odisha, India

Correspondence Address:
Nirmal Kumar Mohakud
Department of Paediatrics, Kalinga Institute of Medical Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_258_19

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Background: Diarrhea is the most common illness in children under 5 years of age, accounting for a financial burden for families in developing countries. Objective: The aim of this study is to determine the out-of-pocket health expenditure for the management of diarrhoeal illness among the under-five children in in-patient and out-patient cases. Methods: A cross-sectional study was conducted during January-April 2018 among 60 under-five children with diarrheal illness reporting to pediatric outpatient department (OPD) and 60 under-five children admitted to pediatric ward of a tertiary care teaching hospital. For determining the out-of-pocket health expenditure, both direct and indirect costs for the management of diarrheal illness were estimated both for out-patient and in-patient cases. The cost of the treatment has been presented as the cost of prehospital visits, during a hospital visit and posthospital visit. Results: Overall, median out-of-pocket health expenditure for the management of diarrheal illness for out-patient and in-patient cases were Rs. 1186 (interquartile range [IQR]: Rs. 510) and Rs. 6385 (IQR: Rs. 5889), respectively. The median direct expenditure for OPD cases was Rs. 778.50 (IQR: Rs. 263) and indirect expenditure for OPD cases were Rs. 407.50 (IQR: Rs. 336) The median direct and indirect expenditure for inpatient cases were Rs. 3823 (IQR: Rs. 1942) and Rs. 2237 (IQR: Rs. 4256) respectively. Only 13% of in-patient cases had some kind of medical insurance. Conclusion: A considerable economic burden is faced by the families for treating diarrhea in under-five children. Improved access to safe drinking water and sanitation, promotion of hand hygiene, exclusive breastfeeding, rotavirus vaccination, and use of oral rehydration therapy will reduce hospitalization and out-of-pocket expenditure. The study findings recommend for appropriate policy for provision of financial protection while seeking health care services.


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