A community-based cross-sectional study on out-of-pocket expenditure for coronavirus disease patients in urban slums, Bengaluru Rural

Background: Coronavirus disease 2019 (COVID-19) has caused unprecedented harm to humanity and economies worldwide. A study of economic impact of COVID-19 patients in urban slums is limited. Aims: Hence, this study was undertaken to estimate the out-of-pocket expenditure (OOPE), and compare amongst admissions in public and private hospitals and home isolation of COVID-19 patients. Patients and Methods: A community-based cross-sectional study was conducted in urban slums under the urban field practice area of a medical college between September 2021 and November 2021. Data from 108 COVID-19 patients were collected by a pre-tested semi-structured questionnaire by interview method. Results: The mean age of respondents was 41.99 ± 10.49. The most common symptom was fever 91.6%, followed by cough 69.4%. History of travel was present in 64% and contact with family member was 69%. The mean OOPE for COVID-19 disease was 36756 INR per patient. Overall, the mean direct cost for COVID-19 admission was 29143 INR and mean indirect cost was 7529.62 INR. On applying Krushkal Wallis test, OOPE for direct cost on COVID-19 patient hospital admission, lab investigations, medications was H=65.85, 53.52, 28.98 with P value< 0.05 respectively and was found statististically significant. Similarly for Indirect cost , Loss of wages, travel expenses of the patient and attenders was H=10.45, 31.23 respectively and was found to be statistically significant at P <0.05. Overall the mean direct cost with government, private, home isolation COVID-19 patients was highly significant χ2 = 33.92, P = 0.000, and mean indirect cost χ2 = 9.48, P = 0.002. Conclusions: The OOPE for COVID-19 disease was high. The direct and indirect cost in government facility was minimal. The government's timely response to the pandemic was able to reduce the costs to the patients or else the economic burden would be higher.