title: Socioeconomic status and impact of treatment on families of children with congenital heart disease.
abstract: OBJECTIVE
  To assess the socioeconomic status, treatment being offered and the impact of congenital heart disease treatment on families.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  The Children's Hospital / Institute of Child Health, Lahore, from 1st March to 31st August 2010.
  
  
  METHODS
  All patients undergoing a cardiac surgical or angiographic intervention were enrolled. Socioeconomic status was assessed by Kuppuswamy socioeconomic status scale with income group modification. The impact was measured by the source of financing, effect on family financing source and schooling and health of siblings.
  
  
  RESULTS
  Of 211 patients undergoing treatment in the study period, surgery was the definitive treatment in 164 (77.7%) and angiographic intervention in 47 (22.3%) patients. Male to female ratio was 1.5:1. The mean age of the patient was 39.1 + 3.2 months (range 01 day to 15 years). Majority of families belonged to middle (66.4%, n=140) and lower (27%, n=57) socioeconomic class. The mean cost of medicines and disposables was PKR 78378.2 ± 8845.9 (US$ 933.1 ± 105.3) in open heart surgery, PKR 12581 ± 7010.8 (US$ 149.8 ± 83.5) in closed heart surgery and PKR 69091 + 60906 in angiographic interventions. In 63.1% patients, families contributed towards these costs either completely (12.3%) or partly (50.8%) with significant contribution from the hospital. Adverse effect on families ranged from leave without pay to losing jobs or business (46%), and selling their assets (11.3%). It also affected schooling and health of siblings (22.7% and 26.1% respectively).
  
  
  CONCLUSIONS
  Majority of children with congenital heart disease belonged to middle and lower socioeconomic status in this study. Main definitive treatment was surgery. The cost of health care facilities posed a marked socioeconomic burden on those families.
authors.affiliation: Department of Paediatric Cardiology, The Children's Hospital and Institute of Child Health, Lahore. a.razzaq.cs@gmail.com
authors.forename: Abdul Razzaq
authors.initials: AR
authors.lastname: Mughal
authors.forename: Masood
authors.initials: M
authors.lastname: Sadiq
authors.forename: Syed Najam
authors.initials: SN
authors.lastname: Hyder
authors.forename: Ahmad Usaid
authors.initials: AU
authors.lastname: Qureshi
authors.forename: S Salman
authors.initials: SS
authors.lastname: A Shah
authors.forename: Mohammad Asim
authors.initials: MA
authors.lastname: Khan
authors.forename: Jamal Abdul
authors.initials: JA
authors.lastname: Nasir
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D017048:Health Care Costs; D006330:Heart Defects, Congenital / Q000191:economics / Q000601:surgery*; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010154:Pakistan; D012923:Social Class; D012959:Socioeconomic Factors