The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families
Open Access
- 2 August 2013
- journal article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 13 (1), 708
- https://doi.org/10.1186/1471-2458-13-708
Abstract
Background Worldwide, acute gastroenteritis represents an enormous public health threat to children under five years of age, causing one billion episodes and 1.9 to 3.2 million deaths per year. In Bolivia, which has one of the lower GDPs in South America, an estimated 15% of under-five deaths are caused by diarrhea. Bolivian caregiver expenses related to diarrhea are believed to be minimal, as citizens benefit from universal health insurance for children under five. The goals of this report were to describe total incurred costs and cost burden associated with caregivers seeking treatment for pediatric gastroenteritis, and to quantify relationships among costs, cost burden, treatment setting, and perceptions of costs. Methods From 2007 to 2009, researchers interviewed caregivers (n=1,107) of pediatric patients (<5 years of age) seeking treatment for diarrhea in sentinel hospitals participating in Bolivia’s diarrheal surveillance program across three main geographic regions. Data collected included demographics, clinical symptoms, direct costs (e.g. medication, consult fees) and indirect costs (e.g. lost wages). Results Patient populations were similar across cities in terms of gender, duration of illness, and age, but familial income varied significantly (p<0.05) when stratified on appointment type. Direct, indirect, and total costs to families were significantly higher for inpatients as compared to outpatients of urban (p<0.001) and rural (p<0.05) residence. Consult fees and indirect costs made up a large proportion of total costs. Forty-five percent of patients’ families paid ≥1% of their annual household income for this single diarrheal episode. The perception that cost was affecting family finances was more frequent among those with higher actual cost burden. Conclusions This study demonstrated that indirect costs due to acute pediatric diarrhea were a large component of total incurred familial costs. Additionally, familial costs associated with a single diarrheal episode affected the actual and perceived financial situation of a large number of caregivers. These data serve as a baseline for societal diarrheal costs before and immediately following the implementation of the rotavirus vaccine and highlight the serious economic importance of a diarrheal episode to Bolivian caregivers.Keywords
This publication has 27 references indexed in Scilit:
- Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspectiveVaccine, 2011
- Progress in the Introduction of the Rotavirus Vaccine in Latin America and the CaribbeanThe Pediatric Infectious Disease Journal, 2011
- The Economic Burden of Diarrheal Disease in a Tertiary Level Hospital, Gauteng, South AfricaThe Journal of Infectious Diseases, 2010
- Impact of community-acquired paediatric rotavirus gastroenteritis on family life: data from the REVEAL studyBMC Family Practice, 2010
- Costs of Diarrheal Disease and the Cost‐Effectiveness of a Rotavirus Vaccination Program in KyrgyzstanThe Journal of Infectious Diseases, 2009
- Potential Cost‐Effectiveness of a Rotavirus Immunization Program in Rural ChinaClinical Infectious Diseases, 2009
- The impact of rotavirus gastroenteritis on the familyBMC Pediatrics, 2009
- Economic Impact of a Rotavirus Vaccine in BrazilJournal of Health, Population and Nutrition, 2009
- Rotavirus disease in Uzbekistan: Cost-effectiveness of a new vaccineVaccine, 2007
- Economic analysis of rotavirus-associated diarrhea in the metropolitan Toronto and Peel regions of OntarioCanadian Journal of Infectious Diseases, 2002