Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study

Abstract Background Sepsis disproportionately affects children from socioeconomically disadvantaged families in low-resource settings, where care seeking may consume scarce family resources and lead to financial hardships. Those financial hardships may, in turn, contribute to late presentation or fa...

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Autores principales:	A. Krepiakevich, A. R. Khowaja, O. Kabajaasi, B. Nemetchek, J. M. Ansermino, N. Kissoon, N. K. Mugisha, M. Tayebwa, J. Kabakyenga, M. O. Wiens
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/eab7a19bf41c4fe1bf5befec22947513
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spelling	oai:doaj.org-article:eab7a19bf41c4fe1bf5befec229475132021-11-21T12:06:11ZOut of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study10.1186/s12913-021-07272-91472-6963https://doaj.org/article/eab7a19bf41c4fe1bf5befec229475132021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07272-9https://doaj.org/toc/1472-6963Abstract Background Sepsis disproportionately affects children from socioeconomically disadvantaged families in low-resource settings, where care seeking may consume scarce family resources and lead to financial hardships. Those financial hardships may, in turn, contribute to late presentation or failure to seek care and result in high mortality during hospitalization and during the post discharge period, a period of increasingly recognized vulnerability. The purpose of this study is to explore the out-of-pocket costs related to sepsis hospitalizations and post-discharge care among children admitted with sepsis in Uganda. Methods This mixed-methods study was comprised of focus group discussions (FGD) with caregivers of children admitted for sepsis, which then informed a quantitative cross-sectional household survey to measure out-of-pocket costs of sepsis care both during initial admission and during the post-discharge period. All participants were families of children enrolled in a concurrent sepsis study. Results Three FGD with mothers (n = 20) and one FGD with fathers (n = 7) were conducted. Three primary themes that emerged included (1) financial losses, (2) time and productivity losses and (3) coping with costs. A subsequently developed cross-sectional survey was completed for 153 households of children discharged following admission for sepsis. The survey revealed a high cost of care for families attending both private and public facilities, although out-of-pocket cost were higher at private facilities. Half of those surveyed reported loss of income during hospitalization and a third sold household assets, most often livestock, to cover costs. Total mean out-of-pocket costs of hospital care and post-discharge care were 124.50 USD and 44.60 USD respectively for those seeking initial care at private facilities and 62.10 USD and 14.60 USD at public facilities, a high sum in a country with widespread poverty. Conclusions This study reveals that families incur a substantial economic burden in accessing care for children with sepsis.A. KrepiakevichA. R. KhowajaO. KabajaasiB. NemetchekJ. M. AnserminoN. KissoonN. K. MugishaM. TayebwaJ. KabakyengaM. O. WiensBMCarticlePublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Public aspects of medicine RA1-1270
spellingShingle	Public aspects of medicine RA1-1270 A. Krepiakevich A. R. Khowaja O. Kabajaasi B. Nemetchek J. M. Ansermino N. Kissoon N. K. Mugisha M. Tayebwa J. Kabakyenga M. O. Wiens Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
description	Abstract Background Sepsis disproportionately affects children from socioeconomically disadvantaged families in low-resource settings, where care seeking may consume scarce family resources and lead to financial hardships. Those financial hardships may, in turn, contribute to late presentation or failure to seek care and result in high mortality during hospitalization and during the post discharge period, a period of increasingly recognized vulnerability. The purpose of this study is to explore the out-of-pocket costs related to sepsis hospitalizations and post-discharge care among children admitted with sepsis in Uganda. Methods This mixed-methods study was comprised of focus group discussions (FGD) with caregivers of children admitted for sepsis, which then informed a quantitative cross-sectional household survey to measure out-of-pocket costs of sepsis care both during initial admission and during the post-discharge period. All participants were families of children enrolled in a concurrent sepsis study. Results Three FGD with mothers (n = 20) and one FGD with fathers (n = 7) were conducted. Three primary themes that emerged included (1) financial losses, (2) time and productivity losses and (3) coping with costs. A subsequently developed cross-sectional survey was completed for 153 households of children discharged following admission for sepsis. The survey revealed a high cost of care for families attending both private and public facilities, although out-of-pocket cost were higher at private facilities. Half of those surveyed reported loss of income during hospitalization and a third sold household assets, most often livestock, to cover costs. Total mean out-of-pocket costs of hospital care and post-discharge care were 124.50 USD and 44.60 USD respectively for those seeking initial care at private facilities and 62.10 USD and 14.60 USD at public facilities, a high sum in a country with widespread poverty. Conclusions This study reveals that families incur a substantial economic burden in accessing care for children with sepsis.
format	article
author	A. Krepiakevich A. R. Khowaja O. Kabajaasi B. Nemetchek J. M. Ansermino N. Kissoon N. K. Mugisha M. Tayebwa J. Kabakyenga M. O. Wiens
author_facet	A. Krepiakevich A. R. Khowaja O. Kabajaasi B. Nemetchek J. M. Ansermino N. Kissoon N. K. Mugisha M. Tayebwa J. Kabakyenga M. O. Wiens
author_sort	A. Krepiakevich
title	Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
title_short	Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
title_full	Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
title_fullStr	Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
title_full_unstemmed	Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study
title_sort	out of pocket costs and time/productivity losses for pediatric sepsis in uganda: a mixed-methods study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/eab7a19bf41c4fe1bf5befec22947513
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Out of pocket costs and time/productivity losses for pediatric sepsis in Uganda: a mixed-methods study

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