In:
PLOS Global Public Health, Public Library of Science (PLoS), Vol. 3, No. 6 ( 2023-6-13), p. e0001873-
Abstract:
Japanese encephalitis (JE) is a leading cause of acute encephalitis syndrome and resulting neurological disability in Asia and the Western Pacific. This study aims to estimate the cost of acute care, initial rehabilitation and sequelae care, in Vietnam and Laos. Methodology We conducted a cross-sectional retrospective study using a micro-costing approach from the health system and household perspectives. Out-of-pocket direct medical and non-medical costs, indirect costs, and family impact were reported by patients and/or caregivers. Hospitalization costs were extracted from hospital charts. Acute costs covered expenditures from pre-hospital to follow-up visits while sequelae care costs were estimated from expenditures in the last 90 days. All costs are in 2021 US dollars. Principal findings 242 patients in two major sentinel sites in the North and South of Vietnam and 65 patients in a central hospital in Vientiane, Laos, with laboratory-confirmed JE were recruited regardless of age, sex, and ethnicity. In Vietnam, the mean total cost was $3,371 per acute JE episode (median $2,071, standard error [SE] $464) while annual costs were $404 for initial sequelae care (median $0, SE $220) and $320 for long-term sequelae care (median $0, SE $108). In Laos, the mean hospitalization costs in acute stage were $2,005 (median $1,698, SE $279) and the mean annual costs were $2,317 (median $0, SE $2,233) for initial sequelae care and $89 (median $0, SE $57) for long-term sequelae care. In both countries, most patients did not seek care for their sequelae. Families perceived extreme impact from JE and 20% to 30% of households still had sustained debts years after acute JE. Conclusions JE patients and families in Vietnam and Laos suffer extreme medical, economic, and social hardship. This has policy implications for improving JE prevention in these two JE-endemic countries.
Type of Medium:
Online Resource
ISSN:
2767-3375
DOI:
10.1371/journal.pgph.0001873
DOI:
10.1371/journal.pgph.0001873.g001
DOI:
10.1371/journal.pgph.0001873.t001
DOI:
10.1371/journal.pgph.0001873.t002
DOI:
10.1371/journal.pgph.0001873.t003
DOI:
10.1371/journal.pgph.0001873.t004
DOI:
10.1371/journal.pgph.0001873.t005
DOI:
10.1371/journal.pgph.0001873.s001
DOI:
10.1371/journal.pgph.0001873.s002
DOI:
10.1371/journal.pgph.0001873.s003
DOI:
10.1371/journal.pgph.0001873.s004
DOI:
10.1371/journal.pgph.0001873.r001
DOI:
10.1371/journal.pgph.0001873.r002
DOI:
10.1371/journal.pgph.0001873.r003
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
3101394-6
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