title: Household costs of seeking outpatient care in Egyptian children with diarrhea: a cross-sectional study.
abstract: BACKGROUND
  Addressing difficulties of seeking and getting health care would lower the burden of diarrhea among ill children from developing countries as Egypt. The purpose of the study is to evaluate the economic burden of diarrhea associated with outpatient visits of children in Egypt by identifying the different types of related costs.
  
  
  METHODS
  This cross-sectional clinic-based survey was done by interviewing parents of 763 children presenting with diarrhea to the outpatient clinics of Pediatric Hospital of Cairo University. Estimated costs included tangible costs (direct, indirect) and intangible costs (forms of suffering). Insurance status of the children was also described. Descriptive statistics were presented in frequency tables, median, minimum, maximum, interquartile range, mean and standard deviation, whenever appropriate.
  
  
  RESULTS
  It was found that 90.7% of the studied children were of low and middle socioeconomic standard with a median monthly family income of US$83 and a median monthly expenditure of LE US$79. The average direct and indirect costs of acute diarrhea per case were US$13.2±19.5 and US$11.3±93.1 respectively. The mean cost per diarrheal episode is US$24.5 which almost consumes 29.5% of the mean monthly income. About 61% of cases sought medical care before visiting our hospital, 43.6% of them visited more than one provider. Awareness about health insurance was found in 72.7% and coverage by a health insurance system in 33%. Of insured patients only 41.4% utilized the insurance services.
  
  
  CONCLUSIONS
  Diarrhea causes great socio-economic burden for families in Egypt, which could result in significant delay in seeking health care.
authors.affiliation: Department of public health and epidemiology, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Abeer
authors.initials: A
authors.lastname: Barakat
authors.forename: Eman Fawzy
authors.initials: EF
authors.lastname: Halawa
mesh_terms: D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003968:Diarrhea, Infantile / Q000191:economics* / Q000628:therapy*; D004534:Egypt; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients
keywords: Economic burden; Egypt; diarrhea
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