Out-of-Pocket Expenditure and Opportunity Cost of Leptospirosis Patients at a Tertiary Care Hospital of Gujarat, India

INTRODUCTION: The study investigates the cost incurred by leptospirosis patients as either out-of-pocket expenditure (OOPE) or opportunity cost (OC) and recommends accordingly for the national program on leptospirosis in India. OBJECTIVES: The objective of this study is to determine leptospirosis-related OOPE and OC at a government tertiary care hospital and to disaggregate the total OOPE into contributing cost domains. MATERIALS AND METHODS: The OOPE data were collected by the personal interview of confirmed leptospirosis cases who took complete treatment at the hospital in year 2009 using a prestructured questionnaire. The patients were interviewed daily until discharge to know daily OOPE. RESULTS: The mean OOPE per patient was Rs. 2157/-, Median: Rs. 1880/-, 25(th)–75(th) percentile: Rs. 1446 – Rs 2587.5). The lowest quintile for OOPE was Rs. 1330/- and the highest quintile was Rs. 2874/-. Loss of daily wages was 68% (Rs. 1458.9/-) of the total OOPE. Other major expenditure included cost of drugs Rs. 308.8/- (14%), expenditure on food Rs. 173/- (8%), and travelling expenses Rs. 204.4/- (9%). CONCLUSIONS: Rs. 2157/- is significant OOPE, and hence, important factor in understanding health-seeking behavior and compliance of leptospirosis patients. The OC (loss of daily wages) amounts to 68% of total OOPE which has to addressed by the government to realize universal health coverage.