Out of Pocket Expenses in Inpatient Burn Care in a Tertiary Hospital of Nepal

Introduction: Burn injuries represent a significant global health burden causing significant economic burden to patient and health care system of country. In Nepal, limited data exist on the out of pocket expenses borne by burn inpatients, hindering effective resource allocation and policy planning. Methods: This is cross-sectional study conducted in K. D Joshi Burn Centre after receiving ethical approval from Institutional Review Board (IRB) of NAMS, Kathmandu. The study population included 33 patients more than 18 yrs of age receiving burn service from the centre. Patients were categorized into superficial partial-thickness burns (SPT), mixed depth partial-thickness burns (MDPT), and full-thickness burns (FT) with 11 patients in each group. Cost components like dressing, surgery, bed charge, investigations and drug treatment analysed average of each excluding the insurance and social security funds. Data were collected using structured proformas and analyzed descriptively. Results: Inpatients were categorized as superficial partial-thickness burns (SPT), mixed depth partial-thickness burns (MDPT) and full thickness burns (FT). The average cost of treating a patient with mostly SPT undergoing admission was estimated at NRs 22, 000 (US 151. 78), that of MDPT was NRs 1, 58, 000 (US 1090. 06) and that of FT was NRs 2, 47, 000 (US 4, 227. 6). The largest cost contributors are drug treatment and dressings. Conclusion: Inpatient burn management in Nepal holds considerable financial burden on patients despite government subsidies. Drug therapy and dressing materials are the principal drivers of out-of-pocket expenditure. These findings focuses the need for better financial protection mechanisms, cost-effective burn care strategies, and adoption of standardized burn registries to inform national health policy and resource planning.