International Journal of Research in Medical Sciences | September 2015 | Vol 3 | Issue 9 Page 2376
International Journal of Research in Medical Sciences
Thakare BS et al. Int J Res Med Sci. 2015 Sep;3(9):2376-2381
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Research Article
Economic burden of hypertension care on households of Malwani slum
of Mumbai: a cross-sectional study
Bharat S. Thakare
1
*, Ambadas Adhav
1
, Suhas Kadam
2
INTRODUCTION
Developing countries like India have witnessed double
burden of diseases since past few decades. The burden of
non-communicable diseases (NCD) is increasing while
communicable diseases (CD) like HIV, Malaria and
diseases related to Nutrition are still not under control.
1,2
NCD constitute more than 60% of deaths globally. Out of
this, Cardio Vascular Diseases (CVD) i.e. Ischemic Heart
Diseases and Stroke constitutes around 50% of deaths.
3
CVD are now proved to be the most common causes of
deaths and disabilities worldwide.
4
Even in Indian
Subcontinent, the rates of CVDs are on higher side.
1
Among CVDs, Hypertension (HT) is a major
contributory factor with subsequent morbidity and
mortality. It is the only modifiable risk factor for CVD.
5
World Health Report 2002 identified hypertension as a
3rd ranked factor for Disability Adjusted Life Years
(DALYs).
5,6
Developing Countries like India and China
are facing the increasing burden of hypertension as
consequences of ageing population and rapidly increasing
ABSTRACT
Background: Hypertension is a chronic non-communicable disease that effects adversely on heart, brain and kidney.
Nearly 2/3rd of all hypertensive patients live in low and middle income countries, so the economic burden of
hypertension is huge. India is one of those countries which spent more than 1/3
rd
of all income on CVD and
hypertension. This study was conceptualized to study the disease and economic burden of hypertension.
Methods: A cross-sectional study was conducted in New Collector Compound (NCC) of Malwani. Five plots of NCC
were selected by simple random sampling. A list of hypertensive patients was prepared by house-to-house survey.
Fifty per cent patients were selected randomly for studying economic burden.
Results: The study covered 447 households and 2360 persons. Eighty participants (3.4%) were found hypertensive.
The average annual total cost of hypertension and related disorders was Rs. 7154. It was Rs. 6073 and Rs. 8235 for
government and private respectively. Only 7.50% households were not incurring any cost of illness. The average
annual out of pocket expenditure (OOPE) was Rs. 4042 and Rs. 7621 for government and private facilities
respectively. Fifteen per cent households were incurring catastrophic expenditure at highest threshold of 40%. The
catastrophic spending led to impoverishment of 34.2% households.
Conclusions: High prevalence of hypertension, high OOPE, high incidence of catastrophic spending and
impoverishment among households intensively reflect the need of interventions. Early preventive measures may be a
key in controlling economic and disease burden. There is need to provide the financial risk protection against the
OOPE for outpatient care.
Keywords: Economic burden, Out of pocket expenditure, Hypertension, Malwani Slum, Mumbai, Non
Communicable Diseases
1
Research officer & Project Manager, MAHAN Trust, Melghat, Maharashtra, India
2
Consultant, Research and Documentation, State Health Systems Resource Centre, Maharashtra, India
Received: 25 July 2015
Accepted: 11 August 2015
*Correspondence:
Bharat S. Thakare,
E-mail: bharat.thakare9206@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150634