title: Health care utilisation in Indian leprosy patients in the era of elimination.
abstract: OBJECTIVE
  The health care utilisation pattern among Indian leprosy patients accessing a tertiary care centre over an 18 month period was studied.
  
  
  METHODS
  A study was conducted at the Dermatology Outpatient Clinic at the Christian Medical College, Vellore, from January 2005 to June 2006. The profile of patients was assessed and a subgroup was interviewed on their healthcare use, including any delays and costs incurred.
  
  
  RESULTS
  198 patients presented of which 115 patients (58.1%) were on treatment for leprosy or a leprosy reaction (active) including 35 new patients (17.7%), and 83 (41.9%) patients were not on active treatment (inactive). 81 patients were interviewed in depth, 14 (17.3%) were new patients included among 54 (66.7%) patients with active disease, and 27 (33.3%) with inactive disease. The average delay from the onset of symptoms to starting treatment in those interviewed was 13.4 months, 7.9 months of which was a patient-related delay and 5.4 months of which was the health care system-related delay. In patients who had been released from treatment, 78.6% (22/28) required care after cure.
  
  
  CONCLUSIONS
  Improved awareness is required to reduce patient-related delays and systems for sustained training need to be in place to tackle the problem of health care system-related delays. Care after cure is a felt need for many patients released from treatment.
authors.affiliation: Department of Dermatology, Venereology, Leprosy, Christian Medical College, Vellore, India.
authors.forename: Lourdhurajan
authors.initials: L
authors.lastname: Renita
authors.forename: Susanne A
authors.initials: SA
authors.lastname: Pulimood
authors.forename: Elizabeth Pushpa
authors.initials: EP
authors.lastname: Eapen
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Muliyil
authors.forename: K R
authors.initials: KR
authors.lastname: John
mesh_terms: D017677:Age Distribution; D044466:Asian People / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities / Q000458:organization & administration*; D006801:Humans; D007194:India; D007407:Interviews as Topic; D007918:Leprosy / Q000175:diagnosis* / Q000191:economics / Q000208:ethnology / Q000628:therapy*; D008297:Male; D009166:Mycobacterium leprae; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors