A Prospective Study To Assess The Out of Pocket Expenditure Among Psychiatric Patients Attending Tertiary Care Service

Anindita, Sandhya Ghai, Nitasha Sharma, ⃰ Shankar Prinja


Introduction:  Mental illnesses are commonly linked with a higher disability and burden of disease, than many physical illnesses. The World Health Organization noted that one in every four people is affected by a mental disorder at some stage of life. Out of pocket payment is the major health financing mechanisms across most of developing countries, often present an enormous burden on underprivileged households. The costs of treatment of psychiatric patients are frequently high enough so that households are unable to get them back from existing resources and hence ultimately slip deeper into poverty. Aim: To assess the out of pocket expenditure of the patients attending psychiatry outpatient services and admitted in psychiatry ward. Methods: A prospective study was undertaken in the department of psychiatry at a tertiary institute of North India to measure the out of pocket expenditure of patients seeking care from OPD or admitted in ward. This study was conducted during the month of July – August 2016 on 200 patients. 10% patients were randomly selected from one day OPD attendance to interview and inpatients were totally enumerated. Socio demographic proforma to assess socio demographic profile and semi structured interview schedule for measuring out of pocket expenditure were used.  Results: The result of the study had shown that among out patients transportation cost was higher (mean 827.81). There was a minimal consultation fee in PGIMER (mean 12.00) and negligible expenditure for psychotherapy (mean 1.67). Among Inpatients hospital bed charges was higher than other cost (mean 6988.25). Total expenditure of hospitalization was high (mean 22311). Among outpatients 63.3% patients had expenditure up to Rs 2500 for last one month and among inpatients 65% patients had expenditure up to Rs 25000 for present hospitalization. Prevalence of catastrophic health expenditure among outpatients was 18.9% and among inpatients it was 25%. Conclusion: Higher transportation cost indicated patients from far distance had come for follow-up and continued their treatment and higher bed charges among inpatients indicated patients had long duration of stay. Special attention given by medical personnel towards the treatment expenditure of patients can help them to reduce their economic burden and continued their treatment.

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