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Cost of Treatment of Valvular Heart Disease at a Tertiary Hospital in North India: Policy Implications

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  • Shankar Prinja

    (Postgraduate Institute of Medical Education and Research)

  • Yashpaul Sharma

    (Postgraduate Institute of Medical Education and Research)

  • Jyoti Dixit

    (Postgraduate Institute of Medical Education and Research)

  • Shyam Kumar Singh Thingnam

    (Postgraduate Institute of Medical Education and Research)

  • Rajesh Kumar

    (Postgraduate Institute of Medical Education and Research)

Abstract

Background Lack of data on the cost of cardiac care is an impediment to evidence-based planning, especially for determining provider payment rates under publically financed health insurance schemes. Objective This study estimates the unit costs of outpatient consultation, hospitalization, intensive care, selected surgical procedures and diagnostics for providing cardiac care for valvular heart disease at a tertiary hospital in India. Methods We undertook an economic costing of cardiac care using both patient and health system perspectives. For the health system costs, a bottom-up costing methodology was used. Data on all resources (capital and recurrent) utilized for the delivery of cardiac care services for valvular heart disease for 1 year were collected. Data on out-of-pocket expenditures was collected from 100 cardiac patients who underwent valve replacement and balloon valvotomy procedures. All estimated costs represent the year 2016–2017. Results The health system cost of an outpatient cardiac consultation was estimated as 182.4 Indian rupees (INR) (US$2.8) and INR334.8 (US$5.2) in the cardiology, and cardio-thoracic and vascular surgery (CTVS) departments, respectively. The cost of hospitalization per bed-day in cardiology, CTVS and the intensive care unit (ICU) was INR1040 (US$16), INR3853 (US$60) and INR12,635 (US$197), respectively. The median out-of-pocket expenditure for valve replacement surgery using mechanical and bio-prosthetic valves was estimated to be INR107,800 (US$1684) and INR154,000 (US$2406), respectively, and for balloon valvotomy was estimated to be INR14,456 (US$367). Overall package cost per mechanical and bio-prosthetic single valve replacement surgery and balloon valvotomy procedure was estimated as INR127,919 (US$1999), INR148,919 (US$2372) and INR14,456 (US$226), respectively. Conclusion Our findings are useful for planning expansion of public sector cardiac care services, developing package rates for publically financed insurance schemes in India and for undertaking research on cost effectiveness of various models of cardiac care.

Suggested Citation

  • Shankar Prinja & Yashpaul Sharma & Jyoti Dixit & Shyam Kumar Singh Thingnam & Rajesh Kumar, 2019. "Cost of Treatment of Valvular Heart Disease at a Tertiary Hospital in North India: Policy Implications," PharmacoEconomics - Open, Springer, vol. 3(3), pages 391-402, September.
    • Handle: RePEc:spr:pharmo:v:3:y:2019:i:3:d:10.1007_s41669-019-0123-6
    DOI: 10.1007/s41669-019-0123-6
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    References listed on IDEAS

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    1. Ankur Sangwan & Shankar Prinja & Sameer Aggarwal & Jagnoor Jagnoor & Pankaj Bahuguna & Rebecca Ivers, 2017. "Cost of Trauma Care in Secondary- and Tertiary-Care Public Sector Hospitals in North India," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 681-692, October.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    3. Planning Commission, 2011. "High Level Expert Group Report on Universal Health Coverage for India," Working Papers id:4646, eSocialSciences.
    4. Mark D Huffman & Krishna D Rao & Andres Pichon-Riviere & Dong Zhao & S Harikrishnan & Kaushik Ramaiya & V S Ajay & Shifalika Goenka & Juan I Calcagno & Joaquín E Caporale & Shaoli Niu & Yan Li & Jing , 2011. "A Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-10, June.
    5. Ministry of Statistics and Prog Implementation (MOSPI), 2015. "Key Indicators of Social Consumption in India Health," Working Papers id:7118, eSocialSciences.
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    1. Shankar Prinja & Sehr Brar & Maninder Pal Singh & Kavitha Rajsekhar & Oshima Sachin & Jyotsna Naik & Malkeet Singh & Himanshi Tomar & CHSI Study Collaborating Investigators & Pankaj Bahuguna & Lorna G, 2020. "Process evaluation of health system costing – Experience from CHSI study in India," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-22, May.

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