Table 3.
Household-level out-of-pocket costs and payment sources (median, IQR), in 2022 US dollars
| Cost components | Outpatient | Inpatient at RD | ICU**** | ||||||
|---|---|---|---|---|---|---|---|---|---|
| All (N = 210) |
RSV positive (n = 21) |
RSV negative (n = 189) |
p-value*** | All (N = 318) |
RSV positive (n = 84) |
RSV negative (n = 234) |
p-value*** | All RSV negatives (n = 8) |
|
| Total out-of-pocket costs | 51 (32–85) | 52 (32–85) | 51 (32–84) | 0.71 | 112 (58–184) | 117 (65–183) | 110 (57–186) | 0.45 | 543 (370–996) |
| (1) Direct medical costs | 22 (13–32) | 26 (16–32) | 21 (12–32) | 0.33 | 24 (13–49) | 38 (20–61) | 20 (12–37) | < 0.001 | 386 (161–813) |
| Consultation fee | 3 (2–4) | 2 (2–3) | 3 (2–4) | 0.20 | 3 (2–6) | 3 (2–6) | 3 (2–5) | 0.66 | 4 (2–6) |
| Medication costs | 15 (9–20) | 15 (8–18) | 15 (9–20) | 0.49 | 3 (0–9) | 6 (1–13) | 2 (0–6) | < 0.001 | 33 (13–62) |
| Laboratory costs | 0 (0–2) | 0 (0–2) | 0 (0–0) | 0.81 | 0 (0–2) | 1 (0–3) | 0 (0–2) | 0.52 | 7 (0–45) |
| Procedure & service cost | 6 (3–11) | 8 (4–13) | 4 (3–11) | 0.12 | 2 (0–16) | 12 (6–23) | 0 (0–13) | < 0.001 | 86 (30–311) |
| Imaging costs | 3 (3–5) | 3 (3–3) | 3 (3–5) | 0.87 | 0 (0–3) | 2 (1–5) | 0 (0–2) | < 0.001 | 0 (0–4) |
| Miscellaneous costs* | 8 (1–13) | 0 (0–0) | 8 (1–13) | – | 9 (3–18) | 10 (4–18) | 9 (2–18) | 0.42 | 105 (79–158) |
| (2) Direct non-medical costs |
5 (2–28) |
4 (2–22) |
5 (2–28) |
0.82 |
35 (3–87) |
27 (3–72) |
38 (3–88) |
0.57 |
76 (42–112) |
| Transport costs | 4 (2–27) | 4 (2–22) | 4 (2–27) | 0.91 | 6 (2–28) | 8 (2–41) | 5 (1–24) | 0.12 | 33 (3–78) |
| Meal costs | 0 (0–0) | 0 (0–0) | 0 (0–0) | 0.18 | 32 (0–63) | 2 (0–39) | 41 (0–70) | < 0.001 | 5 (2–52) |
| Accommodation costs | 0 (0–0) | 0 (0–0) | 0 (0–0) | N/A | 0 (0–30) | 0 (0–0) | 16 (0–32) | < 0.001 | 10 (0–233) |
| Caretaker costs | 0 (0–0) | 0 (0–0) | 0 (0–0) | N/A | 6 (0–38) | 47 (34–60) | 0 (0–13) | 0.08 | 0 (0–0) |
| (3) Indirect costs | 11 (2–26) | 22 (9–34) | 9 (0–25) | 0.09 | 19 (0–69) | 18 (0–69) | 20 (0–69) | 0.93 | 85 (6–253) |
| Lost income** | 9 (0–25) | 17 (9–34) | 8 (0–22) | 0.03 | 17 (0–69) | 12 (0–68) | 17 (0–69) | 0.85 | 13 (4–194) |
| Lost leisure** | 6 (2–6) | 3 (0–6) | 6 (2–6) | 0.18 | 2 (1–6) | 6 (2–9) | 2 (1–5) | 0.05 | 3 (2–5) |
| Family response | |||||||||
| Reducing other expenses | 34.3% | 9.5% | 37.0% | 0.01 | 59.0% | 42.9% | 64.8% | < 0.001 | 25.0% |
| Use personal savings | 87.1% | 100.0% | 85.7% | 0.06 | 86.8% | 94.1% | 84.1% | 0.02 | 100.0% |
| Borrowed | 2.4% | 0.0% | 2.7% | 0.45 | 26.5% | 6.0% | 33.9% | < 0.001 | 12.5% |
| Selling assets | 2.4% | 4.8% | 2.1% | 0.45 | 5.7% | 2.4% | 6.9% | 0.13 | 0.0% |
| Donations | 2.9% | 0.0% | 3.2% | 0.41 | 16.4% | 3.6% | 21.0% | < 0.001 | 0.0% |
| Other | 0% | 0.0% | 0.0% | N/A | 0.3% | 0.0% | 0.4% | 0.55 | 0.0% |
Total out-of-pocket costs = sum of (1–3). These costs were incurred prior to, during, and after hospitalization. (2) and (3) are the same as costs associated with the societal perspective in Table 2
*Miscellaneous costs include medical consumables such as syringes, gloves, and soap
**Opportunity costs of income lost due to missed work were based on the average salary reported by participants in the study, and opportunity costs of lost leisure time were based on the minimum Vietnamese income based on government data for the study period [18]
***Mann–Whitney U p-value comparing between the costs associated with RSV and those associated with no RSV
****No ICU cases were identified as RSV positive
ICU: intensive care unit; IQR: interquartile range; RD: Respiratory Department; RSV: respiratory syncytial virus