Background: Bangladesh's health system is largely financed through out-of-pocket (OOP) payments. We aimed to quantify the direct OOP expenditure incurred by hospitalised patients with dengue during the 2023 epidemic.

Methods: A cross-sectional study was conducted among 428 hospitalised adult patients with dengue at a major public hospital during the 2023 epidemic, collecting detailed OOP expenditure data.

Results: The median total OOP expenditure was US$51 per patient, with medical costs comprising 56% and non-medical costs 44%. Laboratory investigations and travel expenses were the largest contributors.

Conclusions: Hospitalisation with dengue imposes a substantial financial burden on patients in public facilities.