Key Evidence: In a global review of the costs of treating childhood pneumonia, the average costs of a hospitalized case of pneumonia in children under five years of age was US$243 in primary or secondary hospitals in low- and middle-income countries (ranging from US$40 - US$563) and US$559 in tertiary hospitals (ranging from US$20 - US$1,474). In high-income countries, the cost of hospitalized cases averaged US$2,800 in primary or secondary hospitals and more than US$7,000 in tertiary hospitals. Note that in most of these studies, only direct medical costs were included and thus total costs – including non-medical costs and lost wages – would be considerably higher.
Key Evidence: In rural Malawi, where medical care for cholera is free-of-charge, cholera still cost households, on average, US$66 in lost wages of the patient or caregiver and direct, non-medical costs, such as food and transportation. The direct cost to health facilities was $60 per case, twice as much as the 2016 per capita health budget for Malawi that year.
From the VoICE editors: Data on per capita health expenditures by country can be found in the WHO Health Expenditures database here: http://apps.who.int/nha/database/Select/Indicators/en
Key Evidence: In a study in The Gambia – a setting where healthcare is free of charge to patients – pneumococcal disease nonetheless placed a heavy financial burden on families seeking treatment before arrival at the hospital, with families paying for transportation costs, drugs, diagnostic tests and even burial in the case of death. 50-80% of the cost of treating an episode of pneumococcal disease was born by the health system, which still left families to cover a cost up to 10 times their average daily household budget. In addition the estimated treatment cost for inpatient pneumonia of US$109 is nearly 4 times the annual per capita expenditure for health in The Gambia.
Key Evidence: In Malawi, in 17% of cases where children were admitted to the hospital, and in 9% of cases where children were treated as outpatients for diarrhea, household costs associated with treating that episode, exceeded monthly income in a significant number of cases. The costs were significant enough to push families from each income level below the national poverty line for the month in which the illness occurred.