Burden of indirect costs: Are we overlooking this amongst patients with long-term medical conditions?

Background: Increasing prevalence of long-term medical conditions (LTMCs) has made them recognized as the leading cause of diseases and deaths globally. Patients with LTMCs may have to stop work or have their household members stop working to care for them. Objectives: This study determines the indirect cost burden of patients with prevalent long-term medical conditions (LTMCs) using public health facilities in Yenagoa, Bayelsa State. Methods: A cross-section of 339 adult patients attending medical out-patient clinics for four LTMCs namely Hypertension (HTN), Diabetes mellitus (DM), Tuberculosis (TB) & Human Immune deficiency virus (HIV) disease across three specialist hospitals. Indirect cost was determined as number who stopped or reduced work, average missed work days, forgone activities and caregivers’ burden. Results: Greater majority of study participants were females. About a third (29.5%) of participants stopped/reduced work in the past year and the median missed work days per month was 5 days. Patients with non-communicable diseases (52.9%) had higher significant finding of forgoing leisure activity than those with the communicable diseases (30.5%), (p <0.05). Paid work was the most forgone activity in other to attend clinic visits. Children (66.7%) were the most accompanying persons for clinic visits and majority (65.0%) reported having to miss school of work in other to accompany for clinic visits. Conclusions: LTMCs are associated with heavy indirect costs with potentially reduced economic productivity. Findings can guide the design of more responsive policies including work-place programs.