Are We Contented in Achieving Universal Health Coverage in Treating Dengue Patients in Sri Lanka?

Abstract BackgroundAmong infectious diseases, Dengue illness causes a major public health threat in Sri Lanka. The preventive and the curative services place a financial burden on the state health sectorand household cost and out of pocket expenditure also are important cost components embedded with Dengue infection. ObjectiveTo estimate the household costs andout of pocket expenditure incurred due to Dengue infection among adults who received institutional care.MethodsA longitudinal study was conducted from July to December 2018. Fifty patients each from DF and DHF categories were recruited with systematic sampling admitted to an institution in Colombo District, Sri Lanka.Adults residing in Colombo District of Sri Lanka for more than six months prior to Dengue/DHF episode, were recruited based on a systematic sampling method. Details were obtained via an interviewer administered questionnaire. They were interviewed on day of discharge from the hospital and were followed up for two weeks. Unit cost per patient was calculated. The household costs were calculated for three phases; ambulatory cost, costs incurred during hospitalization and post hospitalization costs. These components were described using mean, median, standard deviation and inter-quartile range and out of pocket expenditure were calculatedResultsThe median age in DF group was 38.5 years and in DHF group was 28.5 years.Average household cost was US$127.69(SD=93.32) and US$134.71(SD=94.31) for DF and DHF patients respectively. Among DF patients 98.03% was borne using OOPE and among DHF patients it was 95.57%. In 2016, the average monthly income of a household in Colombo was US$571.82. Thereforenearly 25% of the monthly income had been spent on a single adult with Dengue.Conclusions and RecommendationsIf an adult member is hospitalized with Dengueinfection the Out of pocket expenditure is high, which is nearly 25% of a family’s monthly income.Strengthening the Dengue control programme is the key towards Universal Health Coverage.