Determination of household direct costs in treatment of Shigellosis in Nha Trang, Khanh Hoa province

ABSTRACT

Background: Shigella-induced diarrhea has been considered a major health problem leading to high morbidity and mortality. This disease can lead to dire consequences; however, the true burden of the disease, including the costs and sequalae associated with shigellosis is not yet known. Objectives: (1) To describe the health seeking behavior and the way of payment of population when suffering Shigella; (2) To identify and analyze the direct household costs associated with the treatment of diarrhea due to Shigella. Subjects and method: 290 patients of all ages with positive Shigella diarrhea admitted to public health facilities in Nha Trang, Khanh Hoa province in the period from August 2002 to January 2004 were included in the study. The subjects were divided into three age groups, the first 0-5, second 5-18 and the last one was over 18 years old. Patients and their relatives were interviewed at three stages - day 7, day 14 and day 90 - to obtain all the required information. Results: 134 of 290 patients (47%) paid for using the other health care services before admission to the study\u2019s facilities. The average direct cost per episode for the patients at group aged 0-5 was 129,000 VND, group aged 6-18 was 59,267 VND and over 18 years old was 173,531 VND; it was 131.960 VND for three groups. Comparison with the average household expenditure for health care, it was higher in the poorer group and it was lower three times than the richest group. The average direct medical cost per episode was higher the average direct non-medical cost per episode for all groups. Conclusions: The average direct cost per episode of Shigellosis treatment was rather high especially the average direct cost for the treatment at the health facility. It was also high compared with the average expenditure for health per capita so that it becomes large economic burden for households.