Incidence of catastrophic health expenditures for households: An example of medical attention for the treatment of severe childhood malaria in Kinshasa reference hospitals, Democratic Republic of Congo
Incidence of catastrophic health expenditures for households: An example of medical attention for the treatment of severe childhood malaria in Kinshasa reference hospitals, Democratic Republic of Congo
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DOI：
10.1016/j.jiph.2014.08.008
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发表时间：
2015-03-01
影响因子：
6.7
通讯作者：
Dramaix, Michele
中科院分区：
文献类型：
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作者：
Ilunga-Iunga, Felicien;Leveque, Alain;Dramaix, Michele
这项研究的目的是估计金沙萨有受严重疟疾影响的儿童的家庭所面临的灾难性卫生支出的发生率。共有1350名15岁以下因严重疟疾住院的儿童被纳入研究。我们根据两个阈值分析了面临灾难性支出的家庭的发生率：家庭支付能力的40%和家庭总消费的10%。以“支付能力的40%”为门槛，灾难性卫生支出的发生率达到81.1%，以“总消费以上10%”为门槛，这一估计达到46.4%。关于>40%的支付能力门槛，在有孩子住进公立医院的家庭中，灾难性支出的发生率较高（调整比值比[aOR] 3.7）和私立医院（aOR 59.1），贫困家庭（aOR 13），中等社会经济地位家庭（aOR 3.2）、女户主家庭（aOR 2.9）、有儿童患有神经系统疾病（aOR 4.8）和呼吸窘迫（aOR 3.6）的家庭以及选择院前疗养院的家庭（aOR 2.7）。当应用高于总消耗阈值10%时，获得了类似的结果。政府增加对医疗服务的供资将减少最贫穷家庭面临的灾难性保健支出。(C)2014年沙特国王本阿卜杜勒阿齐兹健康科学大学。由爱思唯尔有限公司出版。保留所有权利。
This study aimed to estimate the incidence of catastrophic health expenditures faced by households in Kinshasa with children affected by severe malaria. A total of 1350 children below the age of 15 year who were hospitalized due to severe malaria were included in the study. We analyzed the incidence of households facing catastrophic expenditures according to two thresholds: 40% of the household's capacity to pay and 10% of the household's total consumption. Based on the '40% of the capacity to pay' threshold, the incidence of catastrophic health expenditures reached 81.1%, and this estimate reached 46.4% for the '10% above total consumption' threshold. Regarding the >40% capacity to pay threshold, the incidences of catastrophic expenditures was higher among households with children who were admitted to state hospitals (adjusted odds ratio [aOR] 3.7) and private hospitals (aOR 59.1), for poor households (aOR 13), for households with medium socioeconomic statuses (aOR 3.2), for female-headed households (aOR 2.9),for households with children affected by the neurological form (aOR 4.8) and respiratory distress (aOR 3.6), and for households who opted for a pre-hospital resort (aOR 2.7). Similar results were obtained when the 10% above the total consumption threshold was applied. Greater government financing of medical attention would lead to a reduction in the catastrophic health expenditures faced by the poorest households. (C) 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.