Technological advancement and modernisation of medicine has come with a hefty price tag, which healthcare providers and clients are grappling with. However, this has also led to more definitive, democratised and precise solutions in healthcare, which is quite important. Though technology is the favourite whipping boy when costs are calculated, they bring a definitive value that we cannot do without. In both healthcare systems where the expenses are borne by the state or insurance companies and when borne by the client, there are some significant sundries, which add up quite significantly. These expenses in the developing world are quite significant because they hold the key to pushing an individual with a not so robust financial condition further into poverty. Data from India show that most of the expenditure (74%) was incurred for outpatient treatment, and not for hospital care; only 26% was for inpatient treatment.
Travel to hospital by personal and public transport, parking if applicable over long periods of time are extremely significant expenses. The cost of transporting ill people and their relatives in an already financially stretched household is telling. The cost of waiting at a public health facility that does not have operating hours convenient to working patients is the loss of that day’s wage. In addition, a large population waiting to access free care ensures long waiting times, causing missed work days and consequent loss in income. Having an ill person at home means not just the cost of medicines and several other expenses, such as costs to treat side effects and other ancillary tests and procedures. Illness demands rest hence employment must wait. Patients also require appropriate nutrition. Therefore, expenses on food increase and others within the household must give up either their share of food or add to the household costs.
Poverty exacerbates disease, but disease further pushes households into poverty. This may lead to families being malnourished, selling of assets, taking children out of education and stigmatisation.
Though correcting the social determinants of disease is an extremely complex problem, internet and mobile technology may help. Telemedicine and remote monitoring of patients may help in reducing unnecessary hospital visits and appropriate intervention when needed. Digital platforms maybe used for continuous patient education and advice on matters of health and related issues. Multidisciplinary care can be instituted and most importantly, the quality of care, which now continuous can make a big difference.
The cost of instituting mobile healthcare is not prohibitive, but can make a big difference to the physical, emotional and financial health of the patient and the family.