The Expenditures of Stroke Outpatients at Srinagarind Hospital

Abstract

Rationale: Stroke or the disease of cerebral blood vessel, or paralysis is a prevalent disease and a major public health problem of Thailand. Stroke is a chronic disease with prolonged development at all stages that leads to the paralytic state, the state that prevents the patient from doing their daily routine and thus have to rely on the others. This means an additional expense both from treatment at hospital and home care. The study of Neurological Institute in 1995 reported that the average expense of outpatients which involved transportation cost to receive their treatment at the hospital was 1,400 baht per person per day. Such expense has not been studied at Srinagarind Hospital before.

Objective: To study the average direct and indirect expenses of the stroke outpatients at Srinagarind Hospital during the first trimester of 2008.

Study design : Descriptive research

Setting: The Outpatient Department, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University

Methods: 237 new and former stroke outpatients aged over 20 years old who received treatment from January 1 to March 31, 2008.  The research tool was questionnaire.

Results: The stroke outpatients in the sample group are from 20 to 91 years old, or an average age of 64±12.8 years. The most diagnosis result reveals cerebral infarction (31.6 percent), with a Modified Rankin Score of 1. Concurrent diseases diagnosed include hypertension, Dyslipidemia, and diabetes, respectively. The result shows the direct and indirect expenses of the outpatients’ final visit to the hospital. For the direct expense, the average cost of food is 172.89 baht, the average two-way transportation cost is 517.68 baht, and the average accommodation cost is 625.50 baht. As for the indirect expense, it was found that the outpatients take a two-day leave from work at a maximum, with a loss of an average of 500 baht of income per day. When the outpatients come to the hospital, they are accompanied by 1-3 relatives or an average of 1.16 persons, causing an average reduction of income of 489.15 baht per day. The average total direct and indirect expense becomes 1,959.85 baht per day per one outpatient.

Conclusion : The expense of each stroke outpatient at Srinagarind Hospital is as high as 1,959.85 baht per day. Most of these expenses, are accommodation, transportation, and a loss of income from work. It is recommended that community servicing be established in order to lessen the expense of stroke outpatients by not having to travel to the hospital.

Keywords : expense of stroke and outpatient