Results on the cost of measles in children under five in Bangladesh are available ahead of publication in BMC Health Services Research.
From a societal perspective, a hospitalized and an ambulatory episode of measles costed $159 and $18, respectively. The government spent on average $22 per hospitalized episode of measles. Caregivers incurred $131 in economic costs (including productivity loss), including $48 in out-of-pocket payments (medical and non-medical costs) in public facilities for hospitalized care. Costs incurred at private not-for-profit facilities were significantly higher with $182 in economic costs, including $83 in out-of-pocket payments.
In 2018, 2263 cases of measles were confirmed, resulting in $348,073 in societal costs, including $121,842 in out-of-pocket payments incurred by caregivers.
Most patients (77%) used public healthcare facilities to treat the episode of measles, followed by private not-for-profit facilities (23%). None of the private for-profit facility reported measles cases. Household from all socioeconomic status experienced catastrophic health expenditures related to measles. If we consider that a household experienced catastrophic health expenditure when its out-of-pocket payments related to the episode exceeds 40% of the household monthly expenditure excluding food, we observe that 54% of those using public healthcare facilities where some of the medical costs are covered by the government, compared to 64% of those using private facilities.
Methods
The DOVE team conducted a cost-of-illness study in Bangladesh, generating cost estimates from the perspectives of the public healthcare system, the caregivers, and society. The cost estimates cover the use of public, private for-profit and private not-for-profit healthcare facilities from all levels of care, in urban and rural areas. We interviewed caregivers of children with measles at six (of the selected 48) healthcare facilities at the time of discharge and 7–14 days later. All costs are in 2018 US dollars ($).
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