Cost of Care for Non-communicable Diseases: Which Types of Healthcare Providers are the Most Economical in India's Chhattisgarh State?

IF 2 Q2 ECONOMICS
PharmacoEconomics Open Pub Date : 2024-07-01 Epub Date: 2024-04-17 DOI:10.1007/s41669-024-00489-4
Samir Garg, Narayan Tripathi, Kirtti Kumar Bebarta
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引用次数: 0

Abstract

Background: Non-communicable diseases (NCDs) affect a large number of people globally and their burden has been growing. Healthcare for NCDs often involves high out-of-pocket expenditure and rising costs of providing services. Financing and providing care for NCDs have become a major challenge for health systems. Despite the high burden of NCDs in India, there is little information available on the costs involved in NCD care.

Methods: The study was aimed at finding out the average monthly cost of outpatient care per NCD patient. The average cost was defined as all resources spent directly by government and citizens to get a month of care for a NCD patient. The cost borne by the government on public facilities was taken into account and activity-based costing was used to apportion it to the function of providing outpatient NCD care. For robustness, time-driven activity-based costing and sensitivity analyses were also performed. The study was conducted in Chhattisgarh State and involved a household survey and a facility survey, conducted simultaneously at the end of 2022. The surveys had a sample representative of the state, covering 3500 individuals above age of 30 years and 108 health facilities.

Results: The average monthly cost per NCD patient was Indian Rupees (INR) 688 for public providers, INR 1389 for formal for-profit providers and INR 408 for informal private providers and they managed 53.5, 34.3 and 12.0% of NCD patients respectively. The disease profile of patients handled by different types of providers was similar. The average cost per patient was lowest for the primary care facilities in the public sector.

Conclusions: The average direct cost of NCD care for government and citizens put together was substantially higher in case of formal for-profit providers compared with public facilities, even after taking into account the government subsidies to public sector. This has implications for allocative efficiency and the desired public-private provider mix in health systems.

非传染性疾病的医疗成本:印度恰蒂斯加尔邦哪类医疗服务提供者最经济?
背景:非传染性疾病(NCDs)影响着全球大量人口,其负担日益加重。非传染性疾病的医疗保健通常涉及高额自付支出和不断上涨的服务成本。为非传染性疾病筹资和提供医疗服务已成为卫生系统面临的一项重大挑战。尽管印度的非传染性疾病负担沉重,但有关非传染性疾病医疗成本的信息却很少:这项研究旨在找出每位非传染性疾病患者每月的平均门诊费用。平均成本被定义为政府和公民为获得非传染性疾病患者一个月的护理而直接花费的所有资源。政府在公共设施上承担的成本被考虑在内,并使用基于活动的成本计算方法将其分摊到提供非传染性疾病门诊护理的功能上。为了稳健起见,还进行了时间驱动活动成本计算和敏感性分析。该研究在恰蒂斯加尔邦进行,涉及家庭调查和设施调查,于 2022 年底同时进行。调查样本在该邦具有代表性,涵盖 3500 名 30 岁以上的人和 108 家医疗机构:公立医疗机构、正规营利性医疗机构和非正规私营医疗机构管理的非传染性疾病患者分别占 53.5%、34.3% 和 12.0%,每名非传染性疾病患者的月平均费用分别为 688 印度卢比、1389 印度卢比和 408 印度卢比。不同类型的医疗服务提供者所管理的患者的疾病谱相似。公共部门初级医疗机构每名患者的平均成本最低:即使考虑到政府对公共部门的补贴,正规营利性医疗机构与公共医疗机构相比,政府和公民在非传染性疾病护理方面的平均直接成本也要高得多。这对卫生系统的分配效率和理想的公私医疗机构组合产生了影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
审稿时长
8 weeks
期刊介绍: PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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