Table 3.
The relationship of household level wealth scores with illness proportions, care-seeking, incidence, and costs of diarrhea and ARI in rural Bangladesh, 2007
| Indicators | Diarrhea | ARI |
|---|---|---|
| RR† (95% CI) | RR† (95% CI) | |
| Children with illness* that sought care across continuous wealth scores | ||
| Disease (in 14 days) (N = 808) | 0.84 (0.73, 0.96) | 0.93 (0.86, 1.01) |
| Homecare (in 14 days) (N = 808) | 1.06 (0.83, 1.36) | 0.99 (0.77, 1.27) |
| Visited practitioner (in 2 months) (N = 808) | 0.89 (0.78, 1.02) | 0.98 (0.92, 1.06) |
| Visited qualified only | 0.72 (0.40, 1.30) | 0.91 (0.72, 1.15) |
| Visited unqualified only | 0.93 (0.80, 1.08) | 0.99 (0.90, 1.08) |
| Visited both | 0.68 (0.43, 1.06) | 1.11 (0.80, 1.54) |
| Hospitalization (in 1 year) (N = 1,962) | 1.38 (1.05, 1.82) | 0.95 (0.66, 1.38) |
| Incidence per 1,000 child-years across continuous wealth scores | ||
| Disease incidence | 0.83 (0.72, 0.96) | 0.92 (0.83, 1.03) |
| Homecare incidence (N = 808) | 1.05 (0.83, 1.34) | 0.98 (0.75, 1.29) |
| Incidence of visiting practitioner (N = 808) | 0.81 (0.72, 0.91) | 0.96 (0.88, 1.04) |
| Only qualified | 0.76 (0.45, 1.27) | 0.89 (0.73, 1.10) |
| Only unqualified | 0.84 (0.74, 0.96) | 0.95 (0.86, 1.05) |
| Both categories | 0.62 (0.42, 0.92) | 1.10 (0.86, 1.39) |
| Incidence of hospitalization (N = 1,962) | 1.33 (1.05, 1.70) | 0.85 (0.65, 1.10) |
| Mean costs per episode of illness (in US$‡) across continuous wealth scores | ||
| Overall cost including homecare, outpatient, and hospitalization (N = 808) | 0.87 (0.63, 1.20) | 1.12 (0.93, 1.37) |
| Homecare (N = 808) | 1.10 (0.87, 1.39) | 1.51 (1.24, 1.84) |
| Outpatient care (N = 808) | 0.96 (0.74, 1.26) | 1.16 (0.99, 1.36) |
| Qualified only | 0.98 (0.52, 1.83) | 1.56 (1.19, 2.05) |
| Unqualified only | 0.93 (0.68, 1.28) | 1.03 (0.87, 1.22) |
| Both | 1.46 (0.90, 2.35) | 1.64 (1.17, 2.31) |
| Hospitalization (N = 1,962) | 0.90 (0.74, 1.09) | 1.03 (0.87, 1.23) |
| Mean cost of illness per 1,000 child-years across continuous wealth scores (in US$‡) | ||
| Overall cost including outpatient and hospitalization (N = 808) | 1.07 (0.92, 1.25) | 0.95 (0.87, 1.04) |
| Outpatient care (N = 808) | ||
| Homecare | 1.23 (1.00, 1.50) | 1.50 (1.36, 1.65) |
| Visiting any practitioner | 0.83 (0.74, 0.94) | 1.15 (1.06, 1.25) |
| Direct§ | 0.98 (0.85, 1.13) | 1.23 (1.11, 1.36) |
| Indirect∥ | 0.71 (0.64, 0.80) | 1.06 (0.98, 1.14) |
| Visiting qualified only | ||
| Total | 0.77 (0.57, 1.04) | 1.34 (0.93, 1.91) |
| Direct§ | 0.65 (0.55, 0.76) | 1.44 (1.03, 2.01) |
| Indirect∥ | 0.81 (0.60, 1.12) | 1.16 (0.77, 1.74) |
| Visiting unqualified only | ||
| Total | 0.83 (0.71, 0.97) | 1.01 (0.92, 1.11) |
| Direct§ | 1.00 (0.84, 1.18) | 1.09 (0.98, 1.21) |
| Indirect∥ | 0.69 (0.60, 0.81) | 0.94 (0.86, 1.03) |
| Visiting both qualified and unqualified | ||
| Total | 0.88 (0.56, 1.37) | 2.03 (1.29 (3.20) |
| Direct§ | 0.96 (0.53, 1.73) | 1.85 (1.08, 3.17) |
| Indirect∥ | 0.80 (0.56, 1.15) | 0.94 (0.86, 1.03) |
| Hospitalization (N = 1,962) | ||
| Overall cost | 1.17 (0.89, 1.55) | 0.87 (0.54, 1.41) |
| Direct cost§ before hospitalization | 1.66 (1.28, 2.16) | 1.20 (0.87, 1.65) |
| Direct cost§ during hospitalization | 1.15 (0.89, 1.49) | 0.82 (0.48, 1.40) |
| Indirect cost∥ | 1.15 (0.85, 1.55) | 0.93 (0.61, 1.40) |
| Mean cost of illness per household in the year preceding the interview across continuous wealth scores (in US$‡) | ||
| Overall cost including homecare, outpatient care, and hospitalization (N = 808) | 0.91 (0.69, 1.21) | 1.00 (0.86, 1.16) |
| Homecare (N = 808) | 1.22 (0.86, 1.74) | 1.49 (1.12, 1.96) |
| Outpatient care (N = 808) | 0.89 (0.68, 1.17) | 1.19 (1.01, 1.41) |
| Visited qualified only | 0.71 (0.54, 0.93) | 1.37 (0.93, 2.04) |
| Visited unqualified only | 0.91 (0.65, 1.25) | 1.06 (0.89, 1.27) |
| Visited both health-care practitioners | 0.91 (0.56, 1.48) | 1.97 (1.22, 3.16) |
| Hospitalization care (N = 1,962) | 1.23 (0.86, 1.76) | 0.99 (0.64, 1.53) |
| Direct cost§ before hospitalization | 1.79 (1.23, 2.59) | 1.26 (0.93, 1.72) |
| Direct cost§ after hospitalization | 1.20 (0.81, 1.77) | 0.94 (0.56, 1.57) |
| Indirect cost∥ | 1.21 (0.81, 1.79) | 1.05 (0.68, 1.61) |
ARI = acute respiratory illness; CI = confidence interval; RR = risk ratio.
*
Diarrhea or ARI.
†
RR < 1 indicates an inverse relationship between health outcome and wealth, and/or between cost of treatment and wealth; RR > 1 indicates a direct relationship between health outcome and wealth and/or between cost of treatment and wealth. For example, if RR for diarrhea (in 14 days) = 0.84, this indicates that for every unit increase of household wealth there were 16% fewer cases of diarrhea.
‡
US$1 = taka 69 using the 2007–2008 exchange rate.
§
Direct costs refer to cost of visiting/registration, medicine, diagnostics, and transportation.
∥
Indirect costs refer to costs related to wage loss.