The cost of dengue shock and septic shock in Vietnam: a patient-centred economic analysis

Abstract Background Dengue shock (DS) and septic shock (SS) are the most common infectious causes of shock in Vietnam. Little is known about the cost of an episode of DS or SS from the patient perspective. We aimed to describe the direct medical, non-medical and productivity costs associated with DS and SS. Methods We recruited adults with DS and SS to a prospective observational study at the Hospital for Tropical Diseases, Ho Chi Minh City, from 2019 to 2021. We collected hospital bills, insurance status and out of pocket payments, and conducted an economic questionnaire at discharge, 1, 3 and 6 mo later. We calculated the proportion incurring catastrophic health expenditure (CHE) and catastrophic costs. Results We recruited 127 adults with DS, of whom 118 survived, and 35 with SS, of whom 24 survived; 18.9% and 71.4% with DS and SS, respectively, incurred CHE. When non-medical and productivity costs were considered, the true cost of illness was 6.3 and 6.7 times higher than the hospital bill for DS and SS, respectively. Conclusions Productivity costs must be counted when assessing the cost of critical illness in low- and lower-middle income countries. It is vital that financial protection systems are extended to cover patients requiring high-cost critical care in Vietnam.