IDEAS home Printed from https://ideas.repec.org/a/spr/pharmo/v3y2019i3d10.1007_s41669-019-0123-6.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s41669-019-0123-6
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1007/s41669-019-0123-6?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pankaj Bahuguna & Indranil Mukhopadhyay & Akashdeep Singh Chauhan & Saroj Kumar Rana & Sakthivel Selvaraj & Shankar Prinja, 2018. "Sub-national health accounts: Experience from Punjab State in India," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-17, December.
    2. Shankar Prinja & Pankaj Bahuguna & Ajay Duseja & Manmeet Kaur & Yogesh Kumar Chawla, 2018. "Cost of Intensive Care Treatment for Liver Disorders at Tertiary Care Level in India," PharmacoEconomics - Open, Springer, vol. 2(2), pages 179-190, June.
    3. Shankar Prinja & Akashdeep Singh Chauhan & Anup Karan & Gunjeet Kaur & Rajesh Kumar, 2017. "Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-19, February.
    4. Keane, Michael & Thakur, Ramna, 2018. "Health care spending and hidden poverty in India," Research in Economics, Elsevier, vol. 72(4), pages 435-451.
    5. Shankar Prinja & Gunjeet Kaur & Rakesh Gupta & Saroj Kumar Rana & Arun Kumar Aggarwal, 2019. "Out‐of‐pocket expenditure for health care: District level estimates for Haryana state in India," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 277-293, January.
    6. Paal Joranger & Arild Nesbakken & Halfdan Sorbye & Geir Hoff & Arne Oshaug & Eline Aas, 2020. "Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 321-334, April.
    7. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    8. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    9. Laurence M. Djatche & Stefan Varga & Robert D. Lieberthal, 2018. "Cost-Effectiveness of Aspirin Adherence for Secondary Prevention of Cardiovascular Events," PharmacoEconomics - Open, Springer, vol. 2(4), pages 371-380, December.
    10. Ties Hoomans & Johan Severens & Nicole Roer & Gepke Delwel, 2012. "Methodological Quality of Economic Evaluations of New Pharmaceuticals in the Netherlands," PharmacoEconomics, Springer, vol. 30(3), pages 219-227, March.
    11. Khan, Md. Tajuddin & Kishore, Avinash & Joshi, Pramod Kumar, 2016. "Gender dimensions on farmers’ preferences for direct-seeded rice with drum seeder in India:," IFPRI discussion papers 1550, International Food Policy Research Institute (IFPRI).
    12. Noémi Kreif & Richard Grieve & M. Zia Sadique, 2013. "Statistical Methods For Cost‐Effectiveness Analyses That Use Observational Data: A Critical Appraisal Tool And Review Of Current Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 486-500, April.
    13. Barbara Graaff & Lei Si & Amanda L. Neil & Kwang Chien Yee & Kristy Sanderson & Lyle C. Gurrin & Andrew J. Palmer, 2017. "Population Screening for Hereditary Haemochromatosis in Australia: Construction and Validation of a State-Transition Cost-Effectiveness Model," PharmacoEconomics - Open, Springer, vol. 1(1), pages 37-51, March.
    14. Christopher Fitzpatrick & Katherine Floyd, 2012. "A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 63-80, January.
    15. Gore, Radhika, 2021. "Ensuring the ordinary: Politics and public service in municipal primary care in India," Social Science & Medicine, Elsevier, vol. 283(C).
    16. Hareth Al-Janabi & Terry N. Flynn & Joanna Coast, 2011. "Estimation of a Preference-Based Carer Experience Scale," Medical Decision Making, , vol. 31(3), pages 458-468, May.
    17. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    18. Ching-Yun Wei & Ruben G. W. Quek & Guillermo Villa & Shravanthi R. Gandra & Carol A. Forbes & Steve Ryder & Nigel Armstrong & Sohan Deshpande & Steven Duffy & Jos Kleijnen & Peter Lindgren, 2017. "A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies," PharmacoEconomics, Springer, vol. 35(3), pages 297-318, March.
    19. Jose L Burgos & Thomas L Patterson & Joshua S Graff-Zivin & James G Kahn & M Gudelia Rangel & M Remedios Lozada & Hugo Staines & Steffanie A Strathdee, 2016. "Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-15, February.
    20. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharmo:v:3:y:2019:i:3:d:10.1007_s41669-019-0123-6. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.