Out-of-pocket nonmedical expenses associated with out-patient treatment of common childhood illnesses

BACKGROUND: Out-of-pocket expenses, medical and non-medical, have an impoverishing effect on the family. OBJECTIVE: Determine non-medical out-of-pocket expenses incurred during out-patient attendance for primary care services. METHODS: A descriptive survey was undertaken at a rural medical college using interviewer-administered questionnaire to parents of children <6 years over a period of 6 weeks. Seventy-six participants were interviewed for collecting demographic data and actual cost on travel and meals. RESULTS: Median expenditure for travel was Indian rupees (INR) 20 with inter-quartile range (IQR) 14-48 and on food it was INR 110 with IQR 40-155. Median total expenditure on the visit was INR 122 with IQR 61-220. Among those who travelled >5 km, 36% attendance was for respiratory complaints, 27% with fever and as many as 86% for vaccination. CONCLUSION: Families in rural India have substantial costs incurred in OPD attendance, most of which is for preventive health care such as immunization.