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Household economic burden of childhood severe pneumonia in Bangladesh: A cost-of-illness study

Sultana, Marufa, Alam, Nur H, Ali, Nausad, Faruque, ASG, Fuchs, George J, Gyr, Niklaus, Chisti, Md Jobayer, Ahmed, Tahmeed and Gold, Lisa 2021, Household economic burden of childhood severe pneumonia in Bangladesh: A cost-of-illness study, Archives of disease in childhood, vol. 106, no. 6, pp. 539-546, doi: 10.1136/archdischild-2020-320834.

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Title Household economic burden of childhood severe pneumonia in Bangladesh: A cost-of-illness study
Author(s) Sultana, Marufa
Alam, Nur H
Ali, Nausad
Faruque, ASG
Fuchs, George J
Gyr, Niklaus
Chisti, Md Jobayer
Ahmed, Tahmeed
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
Journal name Archives of disease in childhood
Volume number 106
Issue number 6
Start page 539
End page 546
Total pages 8
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2021-06
ISSN 0003-9888
1468-2044
Keyword(s) Life Sciences & Biomedicine
Pediatrics
Science & Technology
health services research
statistics
Summary Objective To estimate household cost of illness (COI) for children with severe pneumonia in Bangladesh. Design An incidence-based COI study was performed for one episode of childhood severe pneumonia from a household perspective. Face-to-face interviews collected data on socioeconomic, resource use and cost from caregivers. A micro-costing bottom-up approach was applied to calculate medical, non-medical and time costs. Multiple regression analysis was applied to explore the factors associated with COI. Sensitivity analysis explored the robustness of cost parameters. Setting Four urban and rural study sites from two districts in Bangladesh. Patients Children aged 2–59 months with severe pneumonia. Results 1472 children with severe pneumonia were enrolled between November 2015 and March 2019. The mean age of children was 12 months (SD ±10.2) and 64% were male. The mean household cost per episode was US$147 (95% CI 141.1 to 152.7). Indirect costs were the main cost drivers (65%, US$96). Household costs for the poorest income quintile were lower in absolute terms, but formed a higher proportion of monthly income. COI was significantly higher if treatment was received from urban health facilities compared with rural health facilities (difference US$84.9, 95% CI 73.3 to 96.3). Child age, household income, healthcare facility and hospital length of stay (LoS) were significant predictors of household COI. Costs were most sensitive to hospital LoS and productivity loss. Conclusions Severe pneumonia in young children is associated with high household economic burden and cost varies significantly across socioeconomic parameters. Management strategies with improved accessibility are needed particularly for the poor to make treatment affordable in order to reduce household economic burden.
Language eng
DOI 10.1136/archdischild-2020-320834
Indigenous content off
Field of Research 1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30150582

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.