A person suffering from a noncommunicable disease in Punjab was spending upto Rs 1,100 in a month on doctors and medicines on an average, a study conducted by PGIMER jointly with several government hospitals has found, pointing out lifestyle diseases were imposing a high direct and indirect cost on the people of the state.
Those who need hospitalisation spend an average additional amount of Rs 12,000, apart from their monthly medical expenses.
These findings are contained in the “steps” on risk exposure to NCD in the state that PGI submitted last week to the Punjab government.
According to the study, of 26 per cent of the respondents who have ever suffered from a non communicable disease(NCD), 96 per cent had visited a healthcare facility for treatment, while 46.5 per cent visited a healthcare facility in the 30 days prior to their responding to the survey.
The survey has also revealed that even without visits to the hospital, the average money spent by afflcited indivudals on NCD health care is more than R . 800.
Apart from out of pocket expenditure, the 18-month long survey in which 5127 respondents participated from 22 districts of the state, has also revealed that an individual with NCD, has to suffer indirect cost as well in terms of hours lost in the process of travelling to and waiting at hospitals. Also included are the hours that family members spend in caring for a person with NCD.
The survey has found that in a month, a visit to a health facility averages out to about 10 hours travel time, plus waiting time at the hospitals. Higher proportion of people visit private hospitals than public health centres and hospitals in rural areas.
Prof J S Thakur, Department of Community Medicine, PGI, who led the study told The Indian Express a financial protection in much needed in the state.
“There should be some protection from the government side as people are paying on their own,” he said, adding that they have recommended in the survey that state government should work out preventive health screening package for men and women.
The survey has pointed that out of the total amount spent on availing Out Patient Department (OPD) consultation, highest amount was spent on drugs(49 percent) followed by diagnostic tests (23 percent). “Drug related expenditure is more in OPD consultation as compared to In patients admission (IPD). Provider’s fees constitute 22 percent of total expenditure in IPD admission as compared to 70 percent in OPD consultation,” the survey
On the costs spent by respondents for OPD consultation in 30 days, the survey has pointed that amount of INR 1090 is spent by respondents and amount spent on drugs was Rs 730.
About the hospitalization costs for the treatment, 5.6 percent of respondents were hospitalized during the past 12 months. “Mean(average) number of days for which respondent was hospitalized due to an NCD was 5-6 days…mean amount spent for hospitalization in last twelve months was Rs.11496 and the average amount spent on drugs was Rs 10013,” the survey said.
For the residents in Punjab, there is an indirect health care burden due to NCD in the state. “25.2 percent of respondents reported having received home care from a family member or a friend in 30 days. While a family member or friend had to spent 21 hours in 30 days, 22.6 percent of respondents reported having misused one week of usual activity,” it said.
About the sources of money used for the treatment, the study revealed that two third of respondents reported to have used their current income. “Savings were used by 19 percent of the respondents. Money was borrowed by 13.7 percent of the respondents,” the study has found. “1 percent had to tell items to arrange money for treatment. Only 1.3 percent were reimbursed by insurance companies.”
There is also a less number of people found to be having health insurance. “Only 5.8 percent of the population was found to be having health insurance…a higher proportion of people were enrolled in voluntary health insurance schemes of different agencies, Rashtriya Swasthya Bima Yojana(RSBY), Bhai Kanhaiya sehet bima yojna, Bhagat puran siingh sehat bima yojna(BPSSBY) than mandatory forms of health insurance with Central Government Health Scheme (CGHS) etc,” the study said.