Many do not seek medical care as personal expenses keep increasing

Each year, some 16.4% of patients do not receive health services even if they need them, as personal expenditure as a percentage of total health expenditure has continued to increase in the country, according to a report by the Ministry’s Health Economics Unit. family health and well-being.

Currently, Bangladeshis have to pay 68.50% of their total treatment costs out of pocket, which was previously 67% – a rate already quite high compared to the global perspective, according to the report unveiled during a program titled ” Ways to Reduce Household Spending ”at the InterContinental Hotel on Sunday.

The Health Economics Unit reports that patients spend 64% of their health spending on drugs, while 23% is used to cover hospital expenses (indoors and outdoors) and 8% in for diagnostic purposes.

Only 3% of patients receive drugs from public hospitals and 14.9% obtain diagnostic services. Most patients have to buy drugs from private pharmacies and go to private diagnostic centers. This increases the personal expenses of households and often leads them to face financial disaster.

In 2012, Bangladeshis spent 64% of their total health spending on direct spending. That year, Bangladesh formulated the 2012-32 health care financing strategy by setting a target of reducing direct health expenditure to 32% by 2032. However, instead of lowering, the rate fell to 67 % in 2015 and now it has jumped to 68.5%.

High direct spending is the main obstacle to achieving the Sustainable Development Goals for Bangladesh.

To find a solution to this problem, the Health Economics Unit in collaboration with the World Bank prepared the technical report.

During the report unveiling program on Sunday, Dr Subrata Paul, focal person at the National Health Accounts Unit, presented the research paper titled “Pathways to Reducing High Direct Health Care” and said the Budget allocation for the health sector in Bangladesh is lower compared to other countries.

However, he observed that it is not possible to solve this problem only by increasing the allocation of public funds. “We need to have the capacity to spend so that the budget allocation does not go unused.”

He pointed out that with the introduction of social health insurance, many countries, including China and Thailand, have reduced direct health expenditure for patients.

Such insurance schemes can prove to be effective in the context of Bangladesh, he said, adding: “In order to reduce the out-of-pocket costs of patients, the focus must be on strengthening health care services. primary health. diseases must be made available to people. “

Research found that the direct expense of a Covid patient taking services in a general bed in a public hospital was Tk 6,376 while the expense was Tk 2,42,074 in a private hospital.

On the other hand, a patient undergoing treatment in the intensive care unit of a public hospital had to pay Tk 33,333 out of his own pocket, but the cost was Tk 50,9,059 in a private hospital.

The government spent Tk 1,28,109 for a patient in a general bed in a public hospital and Tk 4,08045 for an intensive care patient.

Dr Nurul Amin, Director of Research (Deputy Secretary) at the Health Economics Unit of the Ministry of Health presented the second research paper on “Diagnosing the Factors Underlying High Personal Health Expenditure” .

Dr Nurul Amin, Research Director (Deputy Secretary) of the Health Economics Unit, presented the second research paper titled “Diagnosing the Factors Underlying High Health Expenditure (OOP)” to the program .

According to the article, patients are forced to use the services of private hospitals due to an inefficient public primary health care system at the village level and insufficient primary health care systems in urban areas. . In addition, public hospitals do not provide all the necessary drugs and there are not enough diagnostic facilities.

Dr Nurul Amin said that due to the apparent lack of barriers to buying drugs, including antibiotics, without a prescription and too much marketing by pharmaceutical companies, reputable doctors as well as charlatans are prescribing excessive medication.

“Patients’ expenses go up because they take more drugs than they need. This cost can be reduced if the use of “generic names” of drugs instead of their “brand names” is made mandatory by reviewing and expanding the list of emergency drugs and following prescription protocol. “

He added that due to a lack of necessary oversight on the quality and price of services in private hospitals, people receiving services are constantly harmed in various ways.

Patient dissatisfaction and sometimes a lack of confidence in this regard lead them to seek services abroad. To meet medical expenses in this way, many people find themselves penniless, losing all their possessions, including residential land.

The Health Economics Unit also presented a set of recommendations to reduce direct household health spending and save them from financial disaster.

These include the introduction of an integrated service system between community clinics and upazila health complexes through the introduction of e-health; increase the capacity of public health centers to the desired level by recruiting and deploying the required workforce, securing testing facilities and providing adequate drugs; the introduction of the accreditation system for private hospitals and increase the government’s capacity to control the cost and quality of services.

Health Minister Zahid Maleque said: “It is important to promote health awareness among the people. Preventing environmental pollution is also important.

“We are working to keep the cost of drugs on a leash, which has been the highest. Non-curable diseases that require lifelong drug dependence add to this high expenditure rate,” the minister said.

Getting treatment abroad is one of the reasons for the increase in personal expenses, he observed.

Treatments for cancer and cardiovascular disease must improve, the minister said, hoping that eight new cancer hospitals that are on the cards will reduce the cost burden in the future.

The minister further suggested that people need to adapt to the culture of the annual checkup.

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