Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh
Background: Diarrhoeal diseases are a major public health challenge, placing immense economic burden on households. We aimed to examine the trends in direct medical costs (DMC), direct non-medical costs (DNMC), and family economic burden (FEB) incurred in the community before seeking care at the Dha...
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| Format: | Article |
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Elsevier
2025-01-01
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| Series: | Clinical Epidemiology and Global Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213398424003439 |
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| author | Md Fuad Al Fidah Md Ridwan Islam Md Mushfiqur Rahman Mohammod Jobayer Chisti A.S.G. Faruque Tahmeed Ahmed Sharika Nuzhat |
| author_facet | Md Fuad Al Fidah Md Ridwan Islam Md Mushfiqur Rahman Mohammod Jobayer Chisti A.S.G. Faruque Tahmeed Ahmed Sharika Nuzhat |
| author_sort | Md Fuad Al Fidah |
| collection | DOAJ |
| description | Background: Diarrhoeal diseases are a major public health challenge, placing immense economic burden on households. We aimed to examine the trends in direct medical costs (DMC), direct non-medical costs (DNMC), and family economic burden (FEB) incurred in the community before seeking care at the Dhaka Hospital. Methods: DMC and DNMC were extracted from the database of the DDSS of Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) from 2012 to 2021. Costs in the community were calculated after adjusting for inflation and converting into international dollars (I$) for 2022. The Jonckheere-Terpstra test examined the trends, and quintile regression was used. Results: The sample size was 14178. The median (IQR) direct cost, DMC, DNMC and FEB were I$26.2(14.5–44.9), I$10.1(3.6–21.3), I$13.11(7.5–22.3) and 3.5 %(1.8–6.9 %) respectively. An overall increasing trend (2.9 % in 2012 to 4.3 % in 2021; p-value<0.001) and a recent declining trend (from 4.6 % in 2020) were seen in FEB. Age, distance from home, time taken to reach the hospital, living inside Dhaka, wealth index, and moderate-to-severe disease were associated with all costs. Adequate maternal media exposure (coef: 0.698; 95%CI: 1.167 to −0.229; p-value = 0.004) and secondary level education of the mother (coef: 0.316; 95 % CI:0.018 to 0.614; p-value = 0.038) were negatively associated, COVID-19 period was positively associated (coef:0.786; 95 % CI:0.591 to 0.981; p-value<0.001) with FEB. Conclusion: FEB showed significant trend from 2012 to 2021. The result indicates the need for increased awareness and health education on using immediate oral rehydration therapy and seeking care directly from facilities when institutional care is needed. |
| format | Article |
| id | doaj-art-883aedbb4c4b46cdaba9456f3ec042e1 |
| institution | Kabale University |
| issn | 2213-3984 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Clinical Epidemiology and Global Health |
| spelling | doaj-art-883aedbb4c4b46cdaba9456f3ec042e12024-11-30T07:10:12ZengElsevierClinical Epidemiology and Global Health2213-39842025-01-0131101846Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in BangladeshMd Fuad Al Fidah0Md Ridwan Islam1Md Mushfiqur Rahman2Mohammod Jobayer Chisti3A.S.G. Faruque4Tahmeed Ahmed5Sharika Nuzhat6Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshNutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh; Corresponding author. Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshClinical and Diagnostic Services, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshNutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshNutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh; Clinical and Diagnostic Services, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh; Office of the Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshClinical and Diagnostic Services, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, BangladeshBackground: Diarrhoeal diseases are a major public health challenge, placing immense economic burden on households. We aimed to examine the trends in direct medical costs (DMC), direct non-medical costs (DNMC), and family economic burden (FEB) incurred in the community before seeking care at the Dhaka Hospital. Methods: DMC and DNMC were extracted from the database of the DDSS of Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) from 2012 to 2021. Costs in the community were calculated after adjusting for inflation and converting into international dollars (I$) for 2022. The Jonckheere-Terpstra test examined the trends, and quintile regression was used. Results: The sample size was 14178. The median (IQR) direct cost, DMC, DNMC and FEB were I$26.2(14.5–44.9), I$10.1(3.6–21.3), I$13.11(7.5–22.3) and 3.5 %(1.8–6.9 %) respectively. An overall increasing trend (2.9 % in 2012 to 4.3 % in 2021; p-value<0.001) and a recent declining trend (from 4.6 % in 2020) were seen in FEB. Age, distance from home, time taken to reach the hospital, living inside Dhaka, wealth index, and moderate-to-severe disease were associated with all costs. Adequate maternal media exposure (coef: 0.698; 95%CI: 1.167 to −0.229; p-value = 0.004) and secondary level education of the mother (coef: 0.316; 95 % CI:0.018 to 0.614; p-value = 0.038) were negatively associated, COVID-19 period was positively associated (coef:0.786; 95 % CI:0.591 to 0.981; p-value<0.001) with FEB. Conclusion: FEB showed significant trend from 2012 to 2021. The result indicates the need for increased awareness and health education on using immediate oral rehydration therapy and seeking care directly from facilities when institutional care is needed.http://www.sciencedirect.com/science/article/pii/S2213398424003439Direct medical costsDirect non-medical costsFamily economic burdenDiarrhoeaBangladesh |
| spellingShingle | Md Fuad Al Fidah Md Ridwan Islam Md Mushfiqur Rahman Mohammod Jobayer Chisti A.S.G. Faruque Tahmeed Ahmed Sharika Nuzhat Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh Clinical Epidemiology and Global Health Direct medical costs Direct non-medical costs Family economic burden Diarrhoea Bangladesh |
| title | Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh |
| title_full | Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh |
| title_fullStr | Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh |
| title_full_unstemmed | Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh |
| title_short | Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh |
| title_sort | community level expenses for under 5 diarrhoeal cases prior to reporting at dhaka hospital a cross sectional analysis in bangladesh |
| topic | Direct medical costs Direct non-medical costs Family economic burden Diarrhoea Bangladesh |
| url | http://www.sciencedirect.com/science/article/pii/S2213398424003439 |
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