Health expenditure and care seeking on acute child morbidities in peri-urban Wardha: a prospective study.
OBJECTIVE
To find out health expenditure in public and private sector consultations for common childhood (under 5) morbidities and to compare the clinical practices and the duration of illness for morbidities treated by public and private doctors.


METHODS
The present prospective study over 12 months period was undertaken in the field practice area of a urban health centre in rural India. We could interview mothers of 202 enlisted children at monthly interval for one year. At each visits, mothers were asked to recall any morbidity for the child in the past four weeks, date of onset of symptoms and relief, source of treatment and recorded both direct and indirect expenditure. The data was entered and analyzed by using Epi_info 6.04 software package.


RESULTS
Overall, there were 625 episodes of respiratory infection, out of which 377 (60.3%) were treated by private doctors, 158 (25.3%) were treated by government doctors and remaining 90 (14.4%) were treated at home. Significantly more episodes treated in government health facilities i.e., 12 (5.7%) were recommended or done laboratory test where only 13 (2.3%) consultations with private doctors were advised or done laboratory tests (p=0.015). Notably, 145 (25.5%) and 17 (8.1%) episodes treated by private doctors and government doctors respectively received injections (p=0.001). Average total expenditure on treatment of child morbidity was 189 INR (10% of total household income). Families with less monthly income (<1500) had significantly more expenditure (16.1%) on treatment of morbidities than those families who had higher (>1500) monthly income.


CONCLUSIONS
About 10% of total household income was spent on the treatment of acute child morbidities. Private providers are preferred for the treatment of acute illnesses where both direct and indirect cost of treatment was high. Household with lower monthly income had to spend more on treatment of their sick children. Hence, while devising PPP and health care financing strategies for urban poor should emphasize to reduce health expenditure.
Dongre
Amol R
AR
Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, 442102, Sevagram, Wardha, Maharashtra, India.
Deshmukh
Pradeep R
PR
Garg
Bishan S
BS
D000208:Acute Disease; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology; D005102:Health Expenditures; D006801:Humans; D007182:Income; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D009017:Morbidity; D009035:Mothers; D010342:Patient Acceptance of Health Care; D017149:Private Sector; D011446:Prospective Studies; D017150:Public Sector; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012871:Skin Diseases / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology
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