A prospective study to assess the out of pocket expenditure among psychiatric patients attending tertiary care service

A prospective study to assess the out of pocket expenditure among psychiatric patients attending tertiary care service

Main Article Content

Anindita Mandal, Sandhya Ghai, Nitasha Sharma Shankar Prinja

Abstract

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). 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. Key word: Out of pocket expenditure

  • Anindita, M.Sc. Nursing (Mental Health Nursing), National Institute of Nursing Education, PGIMER, Chandigarh, Mobile no. 8972221771, Gmail:  anindita.mandal91@gmail.com
  • Dr. Sandhya Ghai, Principal, National Institute of Nursing Education, PGIMER, Chandigarh, Mobile no. 9780680616, Gmail: principal.nine@gmail.com
  • Dr. Nitasha Sharma, Clinical Instructor, National Institute of Nursing Education, PGIMER, Chandigarh, Mobile no. 8289041446, Gmail: nitasha470@yahoo.com
  • Dr. Shankar Prinja, Associate Professor, School of Public Health, PGIMER, Chandigarh, Mobile no. 9872871978, Gmail: shankarprinja@gmail.com

Article Details

Author Biography ##ver##

Anindita Mandal, Sandhya Ghai, Nitasha Sharma Shankar Prinja, All India Institute of Medical Sciences, Rishikesh

Anindita Mandal

Ph.D. Scholar in All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

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References:

. Thyloth M, Singh H, Subramanian V. Increasing burden of mental illnesses across the globe: Current status. Indian Journal of social Psychiatry [Internet]. 2016 [Cited 2016 Jan 4]; 32 (3): 254-6.Available from: DOI: 10.4103/0971-9962.193208

. Lahariya C, Singhal S, Gupta S, Mishra A. Pathway of care among psychiatric patients attending a mental health institution in central India. Indian J Psychiatry [Internet]. 2010 [Cited 2016 Jan 4]; 52(4):333–8. Available from: www.indianjpsychiatry.org/text.asp?2010/52/4/333/74308

. Reddy VM, Chandrasekhar CR. Prevalence of mental and behavioural disorders in India: a meta-analysis. Indian J Psychiatry [Internet]. 1998 Apr [Cited 2016 Mar 6]; 40(2):149-57. Available from: www.indianjpsychiatry.org/text.asp?1998/40/2/149/63246

. Mondal S, Kanjilal B, Peters DH, Lucas H. Catastrophic out-of-pocket payment for health care and its impact on households: Experience from West Bengal, India. Future Health Systems Innovations for equity [Internet].2010 June [Cited 2016 Feb 3]; Available from: www.researchgate.net/publication/266879282...

. Reichert S, Simon T, Halm EA. Physician’s attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med [Internet]. 2000[Cited 2016 Mar7]; 160(18):2799-2803. Available from:doi:10.1001/archinte.160.18.2799

. Gadit AA. Out-of-Pocket expenditure for depression among patients attending private community psychiatric clinics in Pakistan. J Ment Health Policy Econ [Internet]. 2004 April [Cited 2016 Jan 5]; 7(1): 23-8. Available from: https://www.researchgate.net/publication/8456575

. Ke Xu. Catastrophic health expenditure. The Lancet [Internet]. 2003 September [Cited 2016 July 5]; 362(9388):997 doi: http://dx.doi.org/10.1016/S0140-6736(03)14377-2

. Wu EQ, Birnbaum HG, Shi L, Ball DE, Kessler RC, Moulis M et al. The Economic Burden of Schizophrenia in the United States in 2002. J Clin Psychiatry [Internet]. 2005[Cited 2016 May 17]; 66(9) :1122-9. Available from: www.medscape.com/medline/abstract/16187769

. Grover S, Avasthi A, Chakrabarti S, Bhansali A, Kulhara P. Cost of care of schizophrenia: a study of Indian out-patients attenders. Acta Psychiatr Scand [Internet] 2005[Cited 2016 June 6]; 112: 54–63. Available from: www.academia.edu/10300726/Cost_of_care_of_schizophrenia

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