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Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting

INTRODUCTION: The microeconomic impact of surgery for congenital heart disease is unexplored, particularly in resource limited environments. We sought to understand the direct and indirect costs related to congenital heart surgery and its impact on Indian households from a family perspective. METHOD...

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Autores principales: Raj, Manu, Paul, Mary, Sudhakar, Abish, Varghese, Anu Alphonse, Haridas, Aareesh Chittulliparamb, Kabali, Conrad, Kumar, Raman Krishna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482148/
https://www.ncbi.nlm.nih.gov/pubmed/26110639
http://dx.doi.org/10.1371/journal.pone.0131348
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author Raj, Manu
Paul, Mary
Sudhakar, Abish
Varghese, Anu Alphonse
Haridas, Aareesh Chittulliparamb
Kabali, Conrad
Kumar, Raman Krishna
author_facet Raj, Manu
Paul, Mary
Sudhakar, Abish
Varghese, Anu Alphonse
Haridas, Aareesh Chittulliparamb
Kabali, Conrad
Kumar, Raman Krishna
author_sort Raj, Manu
collection PubMed
description INTRODUCTION: The microeconomic impact of surgery for congenital heart disease is unexplored, particularly in resource limited environments. We sought to understand the direct and indirect costs related to congenital heart surgery and its impact on Indian households from a family perspective. METHODS: Baseline and first follow-up data of 644 consecutive children admitted for surgery for congenital heart disease (March 2013 – July 2014) in a tertiary referral hospital in Central Kerala, South India was collected prospectivelyfrom parents through questionnaires using a semi-structured interview schedule. RESULTS: The median age was 8.2 months (IQR: 3.0– 36.0 months). Most families belonged to upper middle (43.0%) and lower middle (35.7%) socioeconomic class. Only 3.9% of families had some form of health insurance. The median expense for the admission and surgery was INR 201898 (IQR: 163287–266139) [I$ 11989 (IQR: 9696–15804)], which was 0.93 (IQR: 0.52–1.49) times the annual family income of affected patients. Median loss of man-days was 35 (IQR: 24–50) and job-days was 15 (IQR: 11–24). Surgical risk category and hospital stay duration significantly predicted higher costs. One in two families reported overwhelming to high financial stress during admission period for surgery. Approximately half of the families borrowed money during the follow up period after surgery. CONCLUSION: Surgery for congenital heart disease results in significant financial burden for majority of families studied. Efforts should be directed at further reductions in treatment costs without compromising the quality of care together with generating financial support for affected families.
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spelling pubmed-44821482015-07-01 Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting Raj, Manu Paul, Mary Sudhakar, Abish Varghese, Anu Alphonse Haridas, Aareesh Chittulliparamb Kabali, Conrad Kumar, Raman Krishna PLoS One Research Article INTRODUCTION: The microeconomic impact of surgery for congenital heart disease is unexplored, particularly in resource limited environments. We sought to understand the direct and indirect costs related to congenital heart surgery and its impact on Indian households from a family perspective. METHODS: Baseline and first follow-up data of 644 consecutive children admitted for surgery for congenital heart disease (March 2013 – July 2014) in a tertiary referral hospital in Central Kerala, South India was collected prospectivelyfrom parents through questionnaires using a semi-structured interview schedule. RESULTS: The median age was 8.2 months (IQR: 3.0– 36.0 months). Most families belonged to upper middle (43.0%) and lower middle (35.7%) socioeconomic class. Only 3.9% of families had some form of health insurance. The median expense for the admission and surgery was INR 201898 (IQR: 163287–266139) [I$ 11989 (IQR: 9696–15804)], which was 0.93 (IQR: 0.52–1.49) times the annual family income of affected patients. Median loss of man-days was 35 (IQR: 24–50) and job-days was 15 (IQR: 11–24). Surgical risk category and hospital stay duration significantly predicted higher costs. One in two families reported overwhelming to high financial stress during admission period for surgery. Approximately half of the families borrowed money during the follow up period after surgery. CONCLUSION: Surgery for congenital heart disease results in significant financial burden for majority of families studied. Efforts should be directed at further reductions in treatment costs without compromising the quality of care together with generating financial support for affected families. Public Library of Science 2015-06-25 /pmc/articles/PMC4482148/ /pubmed/26110639 http://dx.doi.org/10.1371/journal.pone.0131348 Text en © 2015 Raj et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Raj, Manu
Paul, Mary
Sudhakar, Abish
Varghese, Anu Alphonse
Haridas, Aareesh Chittulliparamb
Kabali, Conrad
Kumar, Raman Krishna
Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title_full Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title_fullStr Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title_full_unstemmed Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title_short Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting
title_sort micro-economic impact of congenital heart surgery: results of a prospective study from a limited-resource setting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482148/
https://www.ncbi.nlm.nih.gov/pubmed/26110639
http://dx.doi.org/10.1371/journal.pone.0131348
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