Drug costs of patients admitted to a government hospital; share of public and private expenditure

Abstract

Introduction: Government hospitals are expected to provide free health service which includes drugs for in-patients. However, in practice, in-patients have to purchase drugs from outside when they are treated in government hospitals. The objective of the study was to investigate the drug expenditure of patients during their stay in government hospitals.

Methods: Cost incurred by 189 patients who were treated in a pediatric unit, a medical unit and a surgical unit in Teaching Hospital, Karapitiya for 3 - 10 days were studied. Details of drug cost incurred by patients were collected by interviewing patients, from BHTs, the hospital pharmacy and private pharmacies. Data were collected in two phases - from May to June and October to November in 2015.

Results: The average cost for drugs for a patient was Rs. 1,406.00, Rs. 3,204.00, Rs. 3,678.00 and from government per a patient was Rs. 548.00, Rs. 1,239.00, Rs. 885.00 in pediatric, medical and surgical units respectively. Private expenditure on drugs is significantly higher than that from the government expenditure in all units. The highest percentage was spent for antibiotics both by the government (74%) and by the patients (67.5%). The highest antibiotic cost was recorded in the surgical unit. Surgical unit shows the highest per day difference of expenditure on drug by government and by patient. This difference widened with the number of hospitalised days.

Conclusions: Study shows that patients spent more than the government on drugs and the highest fraction of this is for antibiotics. The highest burden is reported among patients admitted to the surgical unit.