Assessment of expenditure on COVID-19 management among RT-PCR confirmed cases admitted in a tertiary care hospital in Rishikesh: a Cross-Sectional Study

Abstract

Introduction: COVID-19 has affected most people from various socioeconomic dimensions, resulting in
large-scale socioeconomic effects on individuals, households, and communities. Although some countries
have been able to manage the reported cases effectively, uncertainty is always there as to when & where new
cases will emerge. The worldwide COVID-19 pandemic poses a significant emerging threat to the entire
nation's economy, mainly the rising economy of a developing country like India. For the management of
COVID-19, different countries need to identify -effective interventions, and plans and mobilizes resources to
deploy these interventions in a way that enhances health system to work with equal access, efficiency, quality
and financial risk protection. The primary concern with COVID-19 treatment is high out-of-pocket
expenditure, which has been a major driving force for people to end up in financial catastrophe. Hence there is
a need to improve our primary healthcare system and also preventive measures must be enforced strictly by
healthcare professionals. Preventive and promotive aspects of health can prove to be a boon for pandemic
such as COVID-19. Effective advertisement and implementation of government health schemes should be
disseminated among the growing population in India. Methodology: A Cross-sectional descriptive study
was conducted among RT-PCR-positive COVID-19 patients admitted at AIIMS Rishikesh in JanuaryFebruary
2022.
The
direct
and
indirect
cost
of
hospitalization
and
pre-hospitalization
was
calculated
using
a

pre-tested
questionnaire.
Results:
Per
day
direct
cost
mean,
and
SD
(standard
deviation)
is
Rs
1330±
(1327)

and

median, and IQR is 990 (480.6-1891.2), indirect cost mean and SD is Rs.710± (851) and median, and
IQR is 426.1 (150-898.2), total cost mean and SD is Rs.1996± (1893) median and IQR is 1640 (15300-2765).
For Hospitalization this mean and SD is INR Rs 8674± (8097) and the median and IQR is 6760 (3105-11845).
This per-day cost represents a high burden of expenditure. As per this study, 47% of participants have a
Pradhan Mantri Jan Arogya Yojana scheme. Conclusion: The current study found that none of private
insurance was ineffective in reducing the Out-of-Pocket Expenditure significantly. The national flagship
programme PMJAY (Pradhan Mantri Jan Arogya Yajna) has been found to be largely effective in reducing
Out-of-Pocket Expenditure to a marked extent. The main issue with the scheme is that the complete
population was not aware of it and its benefits. As per this study 47% people are covered for COVID-19
treatment. Still, people need to be aware of this health scheme so that this high out-of-pocket expenditure can
be controlled.