Healthcare associated expenses for COVID-19 recovered individuals of the Kathmandu valley.

Research Report.

SUMMARY:

Nepal like most of the Low to middle income countries (LMICs) also faced rapid upsurge of new COVID-19 cases, increased in hospitalization rate and escalated use of health care resources due to COVID-19 pandemic. Due to inadequate coverage of universal healthcare coverage (UHC), and social or medical insurance in Nepal, financial hardships and risks brought about by the COVID-19 pandemic to individual and families were catastrophic and the risk has not been addressed till now. Although, the financial hardships brought by COVID-19 pandemic are important issues, there is dearth of studies evaluating economic impact of COVID-19 disease on infected individuals and families from Nepal. Therefore, this study tried to explore the financial expenses occurred to individuals and families infected with COVID-19 disease from Kathmandu Valley, the capital city of Nepal.
This study used a quantitative survey data collected through the semi-structured questionnaire among randomly selected 667 COVID-19 recovered individuals from Kathmandu valley. The questionnaire provided information on participant’s demographics characteristics, disabilities status, employment status, symptoms and tests done for the confirmation of the COVID-19, and expenses occurred during COVID19. In addition, the questionnaire collected information on economic expenses occurred for medications, medical consultation, and medical examinations taken while staying at home isolation, at isolation center, and at hospital. Furthermore, questions also included expenses for the transportation and ambulatory services used while having COVID-19 disease. Moreover, this study also explored the expenses related to treatment of long term COVID.
Finding of this study suggested 351 (73%) out of 481 participants were not involved in any type of medical or health insurance. Likewise only 120 (25%) of participants has COVID-19 insurance of which very nominal 23 (20%) received reimbursement. Our research highlighted this gap in health insurance coverage as significant finding because 207 (43%) of participants from this study reported losing job or payment while having COVID-19 infections. Our research also indicated that peoples with disabilities living on home isolation and isolation centers have higher economic expenses while having COVID-19 disease. In addition to this, our study also revealed that average expenses to stay at general bed of public hospital for an average of 16days was 85553 and average expenses to stay at ICU with ventilator at private hospital for an average of 13 days was 1390000. Furthermore, our study also indicated a significant association of COVID-19 and long term COVID-19 symptoms with participants sex, age and comorbidity status. Moreover, our study also revealed that expenses related to long COVID-19 was higher among participants who were hospitalized (2644), then participants who stayed at home isolation (195) and isolation center (57). This study generated evidences which will help understand the economic burden imposed by COVID-19 disease among individuals from Kathmandu valley of Nepal and aid policy makers to plan strategies for future investments in COVID-19 pandemic prevention, treatment and management or other similar pandemic outbreaks in future.