Out-of-pocket expenditure and catastrophic health expenditure in patients of leprosy at a tertiary care center in India.

IF 1.6 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2026-08-27 DOI:10.1093/trstmh/trag094

Kavita Kavita, Sukhdeep Singh, Kittu Malhi, Manisha Upreti, Sushma Saini, Arushi Ghai, Ritin Mohindra, Tarun Narang, Sunil Dogra

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Abstract

Objectives: Leprosy continues to impose a significant clinical and socioeconomic burden. Despite free multidrug therapy, patients incur substantial out-of-pocket expenditure (OOPE), leading to catastrophic health expenditure (CHE). Evidence on the economic burden of leprosy in India remains limited.

Methods: A pilot prospective observational study was conducted at a tertiary care center in North India, enrolling 56 patients with leprosy. Data on sociodemographic characteristics, direct and indirect healthcare costs, and income were collected.

Results: The study population had a median age of 30 years, with 73% males, and 68% from rural areas. Multibacillary disease predominated (93%), with complications in 73.2% and a median diagnostic delay of 24 months. Median monthly household income was Indian Rupees (₹)12 000, while median OOPE was ₹1625, largely driven by medicines and travel. CHE was observed in 55.4% of patients. OOPE was significantly higher in multibacillary cases compared with paucibacillary disease (P = .04). A considerable proportion of patients resorted to borrowing money, indicating financial distress.

Conclusion: Leprosy imposes a substantial financial burden, with more than one-half of patients experiencing CHE. Strengthening early diagnosis, decentralizing care, and improving financial protection mechanisms are essential to mitigate economic hardship.

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印度三级保健中心麻风病患者的自付支出和灾难性卫生支出。

目标：麻风病继续造成重大的临床和社会经济负担。尽管有免费的多药治疗，但患者需要大量的自付费用（OOPE），导致灾难性的卫生支出（CHE）。关于印度麻风病经济负担的证据仍然有限。方法：在印度北部的一个三级保健中心进行了一项前瞻性观察研究，招募了56名麻风病患者。收集了有关社会人口特征、直接和间接医疗保健费用以及收入的数据。结果：研究人群的中位年龄为30岁，其中73%为男性，68%来自农村地区。多杆菌病占主导地位（93%），73.2%伴有并发症，中位诊断延迟为24个月。家庭月收入中位数为印度卢比（₹）12000，而家庭月收入中位数为₹1625，主要是由药品和旅游。55.4%的患者出现CHE。多细菌病例的OOPE明显高于少细菌病例（P = 0.04）。相当比例的病人求助于借钱，表明经济困难。结论：麻风病造成了巨大的经济负担，超过一半的患者经历了CHE。加强早期诊断、分散护理和改善财政保护机制对于减轻经济困难至关重要。

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

Transactions of The Royal Society of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.00

自引率

9.10%

发文量

115

审稿时长

4-8 weeks

期刊介绍： Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.