Economic cost of hospitalized non-fatal paediatric dengue at the Lady Ridgeway hospital for children in Sri Lanka

Abstract

Introduction: This is the first cost-of-illness study on dengue in Sri Lanka and compares economic costs incurred by hospital and households in Colombo during hospital stay of paediatric patients. Method: A prospective cross-sectional study was carried out on cost of treating dengue at Lady Ridgeway Children's Hospital Colombo over six months (2012-2013) on randomly selected patients fulfilling diagnostic criteria of dengue. Parent interviews and medical records were used to assess costs incurred by households and hospital. Results: Sample consisted of 130 non-fatal dengue patients [43 dengue haemorrhagic fever (DHF), 87 dengue fever (DF)]. None needed intensive care. Average hospital stay of DHF and DF patients was 4.8 and 3.8 days respectively. Average cost to hospital per case of DHF and DF was SLR 24,856 (USD 191) and SLR 10,348 (USD 80) respectively. Direct and indirect medical and non-medical costs incurred by households were SLR 4,758 (USD 36.6) for DHF and SLR 3,965 (USD 30.5) for DF. Total cost per illness for an episode of DHF was SLR 29,744 (USD 228.8). Cost per episode of DF was SLR 14,326 (USD 110.2). Government incurred 84% and 72% of the total costs of DHF and DF. Conclusions: Publicly funded health care bears much of the economic burden of dengue illness in Sri Lanka. Weighted average cost of treating paediatric dengue in ward settings was SLR 19,422 (USD 149.4), representing 5% of per capita GDP (USD 2923 in 2012). Although funding found by households was only 16% and 28% of total costs of DHF and DF, in those below the 'poverty line', this amounted to 93.7% of monthly per capita income.