1. Introduction:

By analyzing recent health related data and health activities it seems that positive changes has been initiated in Bangladesh health care system. Some health indices progress praised by internationally such as maternal and infant mortality, vaccination, birth control, cholera and arsenic prevention. Government as well as private sector spread the services to the rural area. The quality of health care drastically changed in Bangladesh in the past 20 years. But expenditure of health care or total cost of illness increasing day by day. Due to rising cost of illness or financial burden poor and marginalized people suffering to get better health care services. Existing cost barriers and quality weakness deter use of health care, especially by the poor (Sauerborn, R., Adams, A. et al., 1996). According to Household Income and Expenditure Survey 2010, 15.57 percent could not get access to health care service (Non-treatment) due to high cost of treatment. Every year 100 million people face poverty and another 150 million people suffer due to catastrophic health care cost (WHO, 2010). Recent ICDDR’B study reveals that around 6.4 million or 4 percent people in Bangladesh get poorer every year due to excessive health cost (The Daily Star, 2014).

This study focused on the total cost of illness occurred at the household level from several direction. Analysis for total cost of illness is extremely important because it helps policy makers such as the World Bank, World Health Organization, and National Government to develop ways to protect household from financial (economic) burden of illness. Sometimes this type of research led to change policy- the World Bank withdraw its plea for introducing fees in health sector, which governed its policy discourse in 1980s and 1990s (Sakdapolarak, P., Seyler, T. et al. 2013). Cost of illness studies made significant contribution to quantifying and documenting the health outcome values (Rice, P. D., 2000).

In Bangladesh, in absent of inadequate health insurances public, private health care providers adopted pre-payment mechanism. Where pre-payment mechanism are activated, citizens are forced to pay out-of-pocket from their income and get access barrier to health care due to high cost (Xu, K., Evans, D. B. et al. 2007; WHO, 2010).

Illness enforced high financial burdens on patients as well as their families. Direct and indirect costs of illness were significant but indirect costs were the dominant cost component, financial burden of treatment vary depends on type of diseases (Russell, S., 2004; McIntyre, D. et al., 2006). In many countries, high financial burden occurred due to health service weakness such as poor quality of health care, low coverage, registration fee (Chuma, J. et al. 2007).