Skip to main content

Advertisement

SpringerLink
Log in

Cost Incurred by the Family for Surgery in Their Children: A Bangladesh Perspective

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Cost of getting health services is a major concern in Bangladesh as well as in many other countries. A family has to bear more than half of the health care cost despite many facilities provided by the public hospitals. This out-of-pocket (OOP) expenditure drives many families under the poverty line. The aim of this study was to find out the exact cost incurred by the family for a surgical operation of their child in the public and private sectors in Bangladesh.

Methods

A cross-sectional study was conducted to find out the cost of child surgery in different settings of public and private hospitals in Chittagong division, Bangladesh. Cost of herniotomy was then compared across different settings.

Results

In this study, cost of operation in urban private hospitals was highest mostly due to surgeon and anesthetist fee. The cost was lowest in outreach programs as surgeon fee, anesthetist fee and accommodation cost was nil; food and transport cost was minimum. However, cost of accommodation, food, transport and medicine contributed significantly to OOP expenditure especially in tertiary-level public hospitals, in both indoor and day care settings, and also in private urban hospitals.

Conclusions

Our study provides some insight into the OOP expenditure in different health care settings in Bangladesh. This study might be useful in developing a strategy to minimize the OOP expenditure in this country.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Alkire BC, Shrime MG, Dare AJ, Vincent JR, Meara JG (2015) Global economic consequences of selected surgical diseases: a modelling study. Lancet Glob Health 3:S21–S27. https://doi.org/10.1016/S2214-109X(15)70088-4

    Article  PubMed  PubMed Central  Google Scholar 

  2. Alkire BC, Raykar NP, Shrime MG et al (2015) Global access to surgical care: a modelling study. Lancet Glob Health 3(6):e316–e323. https://doi.org/10.1016/S2214-109X(15)70115-4 Epub 2015 Apr 27

    Article  PubMed  PubMed Central  Google Scholar 

  3. Meara JG, Greenberg SLM (2015) Global surgery as an equal partner in health: no longer the neglected stepchild. Lancet Glob Health 3:S1–S2. https://doi.org/10.1016/S2214-109X(15)70019-7

    Article  PubMed  Google Scholar 

  4. Bangladesh Bureau of Statistics (2011) Population and housing census 2011. http://www.bbs.gov.bd/WebTestApplication/userfiles/Image/Census2011/Bangladesh_glance.pdf

  5. Anonymous (2004) Bangladesh demographic and health survey 2004. National Institute of Population Research and Training (NIPORT) Dhaka, Bangladesh, p 12

  6. Bangladesh Bureau of Statistics (2011) Preliminary report on household income and expenditure survey—2010. http://www.bbs.gov.bd/WebTestApplication/userfiles/Image/HIES/HIES-PR.pdf

  7. Begum F, Kabir MA, Salam MA, Ahmed KS (2002) Factors influencing poverty level in rural Bangladesh: a case study in three villages. Jahangirnagar Univ J Sci 2002(25):235–244

    Google Scholar 

  8. Shrime MG, Dare AJ, Alkire BC, O’Neill K, Meara JG (2015) Catastrophic expenditure to pay for surgery worldwide: a modelling study. Lancet Glob Health 3:S38–S44. https://doi.org/10.1016/S2214-109X(15)70085-9

    Article  PubMed  PubMed Central  Google Scholar 

  9. Meara JG, Leather AJM, Hagander L et al (2015) Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386(9993):569–624. https://doi.org/10.1016/S0140-6736(15)60160-X Epub 2015 Apr 26

    Article  Google Scholar 

  10. Government of the People’s Republic of Bangladesh (2016) Ministry of Health and Family Welfare (MOHFW). Health bulletin. http://app.dghs.gov.bd/localhealthBulletin2016/publish/

  11. Chittagong Civil Surgeon Office (2015) Annual report

  12. Definition of ‘OUT-OF-POCKET expenditure by households on health’ according to OECD.org (2001) OECD health data 2001: a comparative analysis of 30 countries. OECD, Paris, 2001, data sources, definitions and methods. https://stats.oecd.org/glossary/detail.asp?ID=1967 [Accessed on: September 12, 2017]

  13. Van Doorslaer E, O’Donnell O, Rannan-Eliya RP et al (2006) Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data. Lancet 368(9544):1357–1364. https://doi.org/10.1016/S0140-6736(06)69560-3

    Article  PubMed  Google Scholar 

  14. Van Doorslaer E, O’Donnell O, Rannan-Eliya RP et al (2007) Catastrophic payments for Health Care in Asia. Health Econ 16(11):1159–1180. https://doi.org/10.1002/hec.1209

    Article  PubMed  Google Scholar 

  15. WHO. Health financing for universal coverage. Out-of-pocket health payments and catastrophic expenditures

  16. World report. Finding Surgery’s Place on the Global Health Agenda. [Accessed online on 19 November, 2017]. www.thelancet.com. http://dx.doi.org/10.1016/S0140-6736(15)60761-9

  17. Dare AJ, Grimes CE, Gillies R et al (2014) Global surgery: defining an emerging global health field. Lancet 384(9961):2245–2247. https://doi.org/10.1016/S0140-6736(14)60237-3 Epub 2014 May 19

    Article  PubMed  Google Scholar 

  18. Verguet S, Alkire BC, Bickler SW et al (2015) Timing and cost of scaling up surgical services in low-income and middle-income countries from 2012 to 2030: a modelling study. Lancet Glob Health 3:S28–S37

    Article  Google Scholar 

  19. Bickler SW, Weiser TG, Kassebaum N et al (2015) Global burden of surgical conditions. In: Debas HT, Donkor P, Gawande A et al (eds) Disease control priorities. Essential surgery, vol 1, 3rd edn. World Bank, Washington, pp 9–40

    Google Scholar 

  20. Gelband H, Jha P et al. (2015) Cancer: disease control priorities, third edition (volume 3). World Bank, Washington. https://openknowledge.worldbank.org/handle/10986/22552. License: CC BY 3.0 IGO

  21. Bangladesh Bureau of Statistics 2016

  22. WB/WHO Global UHC monitoring report 2016

  23. Quintussi M et al (2015) Economic consequences of ill-health for households in northern rural India. BMC Health Serv Res 15:179. https://doi.org/10.1186/s12913-015-0833-0

    Article  PubMed  PubMed Central  Google Scholar 

  24. Banu T, Chowdhury TK, Kabir M, Talukder R, Lakhoo K (2013) Bringing surgery to rural children: Chittagong, Bangladesh experience. World J Surg 37(4):730–736. https://doi.org/10.1007/s00268-013-1916-x

    Article  PubMed  Google Scholar 

  25. Lukong CS, Jabo BA, Mfuh AY (2012) Colostomy in neonates under local anesthesia: indications, technique and outcome. Afr J Paediatr Surg AJPS 9(2):176–180. https://doi.org/10.4103/0189-6725.99412

    Article  PubMed  Google Scholar 

  26. Sleth J, Coulon M, Fesseau R, Rami L (2017) Locoregional anesthesia for pediatric surgery in remote rural settings: experience of an NGO in Bangladesh. [online] Europepmc.org. http://europepmc.org/abstract/med/21520660. Accessed on 4 Nov 2017

  27. Hagander L, Kabir M, Chowdhury MZ, Gunnarsdottir A, Habib MG, Banu T (2015) Major neonatal surgery under local anesthesia: a cohort study from Bangladesh. World J Surg 39(4):953–960. https://doi.org/10.1007/s00268-014-2895-2

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Power and Participation Research Center [PPRC], Dhaka, Bangladesh, for their help in writing the manuscript.

Author information

Authors and Affiliations

  1. Chittagong Research Institute for Children Surgery (CRICS), 29, Panchlaish R/A, Chittagong, Bangladesh

    Tahmina Banu, Tanvir K. Chowdhury, Tasmiah T. Aziz, Arni Das, Nowrin Tamanna, Orindom S. Pulock, Md. Sharif Imam, Anwarul Karim, Mastura Akter & Adnan Walid

  2. Department of Pediatric Surgery, Chittagong Medical College and Hospital (CMCH), Chittagong, Bangladesh

    Tahmina Banu, Tanvir K. Chowdhury, Md. Sharif Imam & Adnan Walid

Authors
  1. Tahmina Banu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanvir K. Chowdhury
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tasmiah T. Aziz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arni Das
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nowrin Tamanna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Orindom S. Pulock
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Md. Sharif Imam
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anwarul Karim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mastura Akter
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Adnan Walid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tahmina Banu.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 182 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Banu, T., Chowdhury, T.K., Aziz, T.T. et al. Cost Incurred by the Family for Surgery in Their Children: A Bangladesh Perspective. World J Surg 42, 3841–3848 (2018). https://doi.org/10.1007/s00268-018-4700-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-018-4700-0

Search

Navigation