|
Depression is a serious public health problem in
Pakistan because of the disabilities it causes and the cost burden
for the family, given the very low health budget, an average per
capita income of $ 430 and the fact that more than 35% of the population
falls below the poverty line. A prevalence-based analytic study
was conducted on 200 patients with ICD-X diagnosis of depression
attending four private community psychiatric clinics
in Karachi (Pakistan). Of the 200 subjects enrolled, 85% were spending
US$ 51.40 per month on general health expenses and 65% were earning
below US$ 86 per month. All costs, including consultation fees,
medicine, transportation, laboratory tests and hospitalization (if
any) were paid out-of-pocket. As this situation is causing a heavy
economic burden on the public, increasing the health budget and
enhancing preventive efforts are essential, and further research
on health economics is needed along with an appropriate government
database.
|
|
|
Background: Depression is a serious public health problem in Pakistan
because of the disabilities it causes and the cost burden for the family.
About 6% of the Pakistani population suffers from this illness and approximately
50% of those affected seek treatment. The health budget of the country
is very low, average per capita income is US$ 430 and 35% of the population
falls below the poverty line. It follows that depression puts a heavy
economic burden on its sufferers.
Aim: The aim of this study was to estimate the economic burden
on patients suffering from depression who were attending community psychiatry
clinics.
Methods: This is a prevalence-based analysis of mental health
care expenditure in a sample of 200 patients with an ICD-X diagnosis of
depression. The patients attended four private community clinics, run
on a once-a-week basis, with all care paid for by the patients out of
pocket. A questionnaire was designed with a view to gathering information
on out-of-pocket treatment and travel expenditures. The data was subjected
to SPSS analysis.
Results: Among the subjects enrolled in the study (n=200), 85%
were spending over Rs. 3,133 (US $ 51.40) per month as general expenses
on health. Sixty-five percent of the subjects were earning below Rs. 5,000
(US $ 86.00). The majority used the public bus for transportation, costing
the family Rs. 83 (US $ 1.40) per trip. Laboratory investigation costs
were negligible as there is a lesser emphasis on lab tests in psychiatry.
Discussion: The high cost of depression keeps a vast majority
of the population away from ongoing treatment, which contributes to the
misery of the illness and the associated loss of productivity. The national
budget is very low, the average income for the majority is far from satisfactory,
and though partial support from charitable organizations, public sector
hospitals, insurance cover and medical facilities is available, the majority
of needs are unmet. It is essential to increase the health budget and
enhance efforts toward preventive strategies. Further research on health
economics is needed along with an appropriate government database.
|
