HOUSEHOLD COST OF PHYSIOTHERAPY SERVICES FOR STROKE PATIENTS AT TEMA GENERAL HOSPITAL

ABSTRACT Background Stroke is one of the major determinants of mortality and a significant contributor to the global disease burden. It is the leading cause of morbidity and mortality in developed and developing countries imposing enormous economic burden on individuals and society. Available data indicate that stroke is an emerging problem in Sub-Saharan Africa. Most stroke survivors usually experience limitation in physical functioning and require physiotherapy and rehabilitative services in physiotherapy to regain lost personal functions and live normal lives. Costs of seeking physiotherapy service can be extremely high and sometimes unbearable for stroke patients and their households. This study therefore seeks to estimate the household cost of physiotherapy services for stroke patients attending Tema General Hospital. Methods Cross-sectional cost-of-illness study design was used. Data was collected at the Physiotherapy Department of the Tema General Hospital from stroke patients and their households for the estimation of physiotherapy cost. Standard cost-of-illness methods were employed in determining the cost incurred by stroke patients. Direct costs were estimated from therapy related and non-therapy related such as exercise therapy, walking stick, tripod, quadripod and transportation costs respectively. Indirect cost was estimated by valuing the productivity losses to patients and household due to stroke. Consequences of stroke on the patients relative to fear, pain and emotional sufferings were evaluated using the Likert’s Scale for the description of intangible cost. Results The total cost of physiotherapy services estimated was GHS53,369.79 (US$12,829.30), with direct and indirect cost constituting 30% and 70% of the total cost respectively. The average monthly cost of physiotherapy services incurred per patient was estimated at GHS539.09 (US$129.59). The median monthly household income was GHS600.00 (US$144.23). About 94% and 86% of patients felt embarrassed in social situations and feared of falling down in public as a result of their illness respectively (mean scores of 3.5 and 3.2 respectively). Patients bothered by the uncertainty of their health, think about their health more than before the stroke and because of physical health their future are of concern to them were the least affected by patients due to stroke. Conclusion The cost of physiotherapy services incurred by stroke patients and household is high. There is therefore the urgent need for policy and decision makers to consider this in their strategic planning and budgeting for rolling out physiotherapy service centres to help ameliorate the financial burden on stroke patients.