The financial burden of dengue and its coping mechanism by household: a mixed-method study in Khordha District, Odisha, India

AIMS: mosquitoes, presents a wide clinical spectrum ranging from mild febrile illness to severe manifestations such as dengue hemorrhagic fever. It poses a substantial global health concern, with India significantly contributing to its burden. Factors such as rapid urbanization, population density, and favorable climatic conditions facilitate its spread, particularly in states like Odisha. This study aimed to estimate the financial burden imposed by dengue on households in Bhubaneswar, Odisha, and to explore the coping strategies adopted by these households to address the financial burden of dengue. METHODS: A case-based cross-sectional study was conducted between May and July 2022 in Bhubaneswar, part of Khordha District. A total of 200 laboratory-confirmed dengue patients were enrolled. Quantitative data on sociodemographic details, health facility choices, and expenditure specifics were collected using structured questionnaires. In-depth interviews were conducted with a subset of patients and caregivers to understand the broader socioeconomic impact. Data analysis involved descriptive statistics, bivariate analysis, and linear regression. RESULTS: Majority of patients were urban residents, predominantly males aged 21-40 years. Private healthcare incurred significantly higher costs than government facilities (INR 21,859 versus INR 1225). The average out-of-pocket expenditure (OOPE) was INR 5567, disproportionately affecting females, older age groups, higher-income individuals, and married participants. Most households (93%) utilized savings, while only 3% relied on health insurance as a coping strategy. CONCLUSION: Dengue fever inflicts a considerable financial and emotional toll on households in Odisha. The findings underscore the urgent need to strengthen public health infrastructure, increase awareness of financial protection schemes, regulate private healthcare costs, and integrate psychosocial support into dengue management strategies.