Willingness and Ability to Pay for Critical Care Treatment for Non-COVID Illness during the COVID-19 Pandemic: A Prospective Observational Study in a Tertiary Care Centre in India.

Background and aims: The COVID-19 pandemic impacted families financially. In this context, we assessed caregivers' willingness-to-pay (WTP) for the treatment of a critical illness among non-COVID admissions. Patients and methods: This prospective study was conducted over 1 year in a 38-bed level-3 adult medical intensive care unit (ICU) at a not-for-profit tertiary care teaching hospital in India. Intensive care unit costs were assessed using a bottom-up micro-costing approach. Utility score was evaluated on day 2 by the intensivist on a scale of 0 to 1 with increments of 0.1; 0 indicating death/severe disability and 1 indicating cure/perfect health. Caregivers' WTP was assessed by the admitting physician using the bidding method. Demographic details, Acute Physiology and Chronic Health Evaluation (APACHE) II score, ICU outcome, and costs were recorded. Willingness-to-pay and actual caregiver contribution were expressed as percentages of the total hospitalization cost. Results: The mean [standard deviation (SD)] age ( Conclusion: Critical illness imposes substantial financial burden on families. Caregivers were WTP more for sicker patients with lower utility scores. Subsidy for treatment was required despite caregivers' final payment exceeding their initial WTP.