Poster Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Cost of tertiary care treatment for Rheumatic Heart Disease in India (#223)

Jyoti Dixit 1 , Shankar Prinja 1 , Shyam K Singh Thingnum 1 , Yashpal Sharma 1 , Rajesh Kumar 1
  1. PGIMER, Chandigarh, CHANDIGARH, India

Several initiatives to provide affordable and accessible cardiac care services, including creation of a network of AIIMS like institutions under Pradhan Mantri Swasthya Suraksha Yojana, Rashtriya Bal Swasthya Karyakram for screening of school children for heart related ailments like Rheumatic Heart Disease, are currently being implemented in India.  However, lack of data on the cost of cardiac care is an impediment to the evidence based planning for such initiatives. So, we undertook an economic costing of cardiac care using bottom-up costing methodology from both patient and health system perspective. Data on all resources (capital & recurrent) and out-of-pocket expenditures for one year was collected.  The results of our study showed per day-care consultation at cardiology and Cardio-thoracic and vascular surgery OPD costs INR 311(USD 4.8) and INR 547(USD 8.5) respectively. Per test costs for ECHO, ECG, TMT and Holter were INR 358 (USD 5.6), INR 18(USD 0.3), INR 963 (15 USD), INR 1892 (USD 29.5) respectively. The cost per bed-day hospitalization in Cardiology & CTVS wards and I.C.U was INR 1,040 (USD 16) and INR 3,853 (USD 60) and INR 12,635 (USD 197) respectively. Per unit cost for MVR, AVR, TVR, DVR  and Triple valve surgery were INR 43,311 (USD 677),  INR 43739 (683), INR 36969 (USD 578), INR 43208 (USD 675) and INR 57,771 (USD 90) respectively. Per unit cost of any valve replacement on average was INR 40,178 (USD 628). The mean Out-of-pocket expenditure for valve replacement was INR 1,76,391 (USD 2756). The estimates generated can be used for estimating the cost effectiveness of cardiac care services.