title: Direct costs of hospitalization for rotavirus gastroenteritis in different health facilities in India.
abstract: OBJECTIVE
  Diarrhoeal disease is the fifth leading cause of all mortality globally. To this burden, rotavirus contributes over half a million deaths annually. This pilot study was conducted to determine the economic burden of diarrhoeal episodes on families from different geographical regions accessing medical facilities in India.
  
  
  METHODS
  Participants were enrolled from four study sites with eight reporting hospitals, categorized as non-profit and low cost, private and government facilities between November 2008 and February 2009. Questionnaires detailing healthcare utilization, medical and non-medical expenditure and lost income were completed by families of children < 5 yr of age hospitalized for gastroenteritis. All available faecal samples were tested for rotavirus.
  
  
  RESULTS
  A total of 211 patients were enrolled. The mean total cost of a hospitalized diarrhoeal episode was ` 3633 (US$ 66.05) for all facilities, with a marked difference in direct costs between governmental and non-governmental facilities. Costs for rotavirus positive hospitalizations were slightly lower, at ` 2956 (US$ 53.75). The median cost of a diarrhoeal episode based on annual household expenditure was 6.4 per cent for all-cause diarrhoea and 7.6 per cent for rotavirus diarrhoea. Of the 124 samples collected, 66 (53%) were positive for rotavirus.
  
  
  CONCLUSIONS
  Data on direct costs alone from multiple facilities show that diarrhoeal disease constitutes a large economic burden on Indian families. Affordable, effective vaccines would greatly reduce the economic burden of severe gastroenteritis on patients, families and the government.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
authors.forename: T V
authors.initials: TV
authors.lastname: Sowmyanarayanan
authors.forename: Tushar
authors.initials: T
authors.lastname: Patel
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarkar
authors.forename: Shobha
authors.initials: S
authors.lastname: Broor
authors.forename: Shobha D
authors.initials: SD
authors.lastname: Chitambar
authors.forename: Triveni
authors.initials: T
authors.lastname: Krishnan
authors.forename: Rashmi
authors.initials: R
authors.lastname: Arora
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology* / Q000821:virology*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007194:India / Q000453:epidemiology; D010865:Pilot Projects; D012400:Rotavirus Infections / Q000191:economics / Q000453:epidemiology*; D011795:Surveys and Questionnaires