Valuing out-of-pocket expenditure and health related quality of life of COVID-19 patients from Gujarat, India

Abstract

Background: COVID-19 has financially burdened Government's healthcare system as well as households with COVID-19 patients. Present study aims to value the out-of-pocket expenditure and health-related quality of life (HRQOL) using EQ-5D-5L among COVID-19 patients who sought treatment in COVID-19 center of a tertiary hospital in Vadodara, Gujarat. Methods: The present analysis is a prospective real-world study. The questionnaire included socio-demographic data, health status, out-of-pocket expenses associated with treatment of COVID-19, and EQ-5D-5L scale. The relationships of all factors and the scores of EQ-5D-5L were analyzed. All costs are reported in Indian Rupees and then converted to US dollars. Result: Out of total 138 participants included in the study, 108 (78.3%) participants had mild to moderate symptoms of COVID-19 infection and were admitted to COVID Care Centre (CCC) while 30 (21.7%) patients had severe disease and were admitted to COVID Intensive Care Unit (ICU). Mean total out of pocket expenditure for the patient admitted to COVID CCC and COVID ICU was INR 11,333.07 (31,707.68) and 27,374.17 (54,205.72) respectively. The respondents obtained a mean EQ-5D-5L index score of 0.755 (±0.180) for patients under COVID CCC and 0.513 (±0.378) for COVID ICU admitted patients. EQ-VAS index was 75.05 (±12.12) and 62 (±16.37) respectively, signifying the HRQoL from patient's perspective. Conclusion: COVID-19 patients have suffered from significant physical and psychological impairment. It is essential to prospectively monitor the individuals who suffered from COVID-19 to understand the long term impact on HRQoL, as well as to inform prompt and efficient interventions to alleviate suffering.