Admission pattern of alcohol related illnesses at General Hospital Ratnapura and their economic burden to the health sector and household

Abstract

To determine the pattern of admission and the demographic and socioeconomic characteristics of patients seeking in-patient services for alcohol related illnesses in medical wards and psychiatric ward of a General Hospital, and to estimate the economic burden imposed by these admissions on the health sector and the households. A descriptive crosssectional study was conducted in male medical wards and the psychiatric ward of the General Hospital Ratnapura. Data were collected using a pre-tested intervieweradministered questionnaire to determine the admission patterns and demographic and socioeconomic characteristics of patients with alcohol related illnesses and to estimate the direct and indirect components of the household cost of hospital stay of a patient. A data sheet was used to record treatment information of specific alcohol related illnesses from Bed Head Tickets. Other relevant data needed for cost estimation were obtained from relevant data sources. A costing exercise was carried out to determine the treatment and accommodation costs to the health system. Out of the sample of 398 admissions 66.58 percent were with alcohol related mental and behavioural disorders and 29.65 percent were with alcoholic liver disease. Largest group (57.54 percent ) was 31-50 years and 3.27 percent was between 12-20 age group. The highest proportion of patients was (64.03 percent ) unskilled laboures. The majority (38.27 percent ) was within the family income of Rs 2500-5000 per month with 17.35 percent gaining less than Rs. 2500 per month. Cost of a patient day not including amount spent for treatment costs, in the two medical wards and the psychiatric ward was Rs.572.45, 499.89 and 667.14 respectively. The highest median cost of treating a patient with alcoholic liver disease was Rs.5076.00 (inter- quartile range 2049.00 - 8346.00) and out of which the major proportion of expenditure (43.55 percent ) was for blood and blood products. Mean household cost due to an admission was Rs. 688.30 of which 65.05 percent was incurred as indirect costs due to lost working days. Mean direct cost to the house hold was Rs 240.55 (SD=352.30) of which 64.67 percent consisted of cost of transportation. The median direct household cost was Rs 68.00 (inter quartile range= 150 - 1225). Most patients seeking in-patient services for alcohol related illnesses at the General Hospital Ratnapura were from a poor socioeconomic background. The economic burden imposed by the admission to the household was mainly due to indirect costs due to lost working days. Alcohol makes poor people even poorer. Since alcohol related illnesses are preventable more priority should be given to reduce the disease burden on the health sector and the household.