Consumer Costs and Satisfaction of Patient Availing Health Care Services from Sir Salimullah Medical College Mitford Hospital

Abstract

Background: Consumers contribute largely in getting healthcare services in Bangladesh. This formal and informal consumer cost leads a large section of population into poverty. Objective of this study was to capture the self-reported consumer cost of illness as well as satisfaction regarding availed healthcare services among patients admitted in Sir Salimullah Medical College Mitford Hospital (SSMCMH). Methods: This cross-sectional survey was conducted from November 2022 to May 2023 among conveniently selected 636 indoor patients of medicine, surgery, orthopedics, pediatrics, and Gynecology & Obstetrics departments of SSMCMH. Mixed method approach was applied to collect data using a semi-structured questionnaire during the discharge of indoor patients whom were selected by stratified sampling method. Results: Respondents had to pay for any of the services, only one fifth (18.10%) said the payment was at the high end. We found that outside facility outweighed inside facility cost, medicine (69.34%) and investigation contributed the largest share. Non-medical costs were a significant component of health expenditure. Though stake of informal tips (2%) were a smaller portion compared to other cost, apparently it was a norm. Patients paid highest for surgical care (Tk 12789.50) and lowest for orthopedic care (Tk 2936.66). There was significant difference between consumer cost of delivery by NVD and CS (p=0.0008). There was significant difference with variation of age (p<0.05), sex (p<0.05), monthly income (p<0.05), but marital status, and year of education was not significant. Consumer satisfaction on payment was seen to be largely dependent on amount they had to spend out of pocket (p<0.05) along with providers behavior and cleanliness of the premises. Conclusion: The study suggested that although direct medical costs are of special importance and it is necessary to protect patients against such costs, patients usually encounter a variety of costs when receiving inpatient services. Findings of this study could help local authority and policy makers to develop strategies within the health system to reduce the burden and ensure patient compliance.

Bangladesh Armed Forces Med J Vol 58 No (1) June 2025, pp 1-6