Incidence and correlates of 'catastrophic' maternal health care expenditure in India
Incidence and correlates of 'catastrophic' maternal health care expenditure in India
复制标题
DOI：
10.1093/heapol/czp032
复制
发表时间：
2009-11-01
影响因子：
3.2
通讯作者：
Anderson, Ian
中科院分区：
文献类型：
--
作者：
Bonu, Sekhar;Bhushan, Indu;Anderson, Ian
该研究利用印度第 60 轮全国抽样调查（2004 年）的数据，调查了印度“灾难性”孕产妇支出 (ME) 的发生率及其相关性。 ME 的数据来自调查前 365 天内发生的 6879 例新生儿。该研究采用了早期对灾难性总医疗保健支出的定义和方法，以衡量“灾难性”ME：(i) 孕产妇保健支出超过年度正常家庭消费支出的 10% (ME-1)，以及 (ii) 孕产妇保健支出超过年度“支付能力”的 40% (ME-2)。 “支付能力”是通过从家庭消费支出中减去国家贫困线家庭支出得出的。平均孕产妇支出因分娩地点而异：在家、在公共设施和私人设施分娩分别为 9.5 美元、24.7 美元和 104.3 美元。 16%的家庭的ME占家庭总消费支出的10%以上（ME-1），而51%的家庭的ME占家庭“支付能力”的40%以上（ME-2）。虽然 ME-1 的发病率随着收入十分之一的增加而增加，但 ME-2 的发病率却相反，反映出较贫困家庭不利用机构孕产妇护理的情况较多，而且无法负担。所有最贫困十分户家庭和99%的第二贫困十分户家庭支付了其支付能力的40%以上。多变量回归结果表明，私人机构的产前护理和分娩护理增加了 ME-1 和 ME-2 的机会（P
Using data from the 60(th) round of the National Sample Survey of India (2004), the study investigates the incidence and correlates of 'catastrophic' maternal expenditure (ME) in India. Data on ME come from 6879 births that took place during 365 days prior to the survey. The study adapts earlier definitions and methods for catastrophic total health care expenditure to measure 'catastrophic' ME as: (i) maternal health care expenditure more than 10% of the annual normative household consumption expenditure (ME-1), and (ii) maternal health care expenditure more than 40% of the annual 'capacity to pay' (ME-2). The 'capacity to pay' was derived by subtracting state-wise poverty-line household expenditure from household consumption expenditure.The average maternal expenditure varied by place of delivery: US$9.5, US$24.7 and US$104.3 for birth at home, in a public facility and in a private facility, respectively. Sixteen per cent of households incurred ME of more than 10% of total household consumption expenditure (ME-1), while 51% households incurred ME of more than 40% of household 'capacity to pay' (ME-2). While incidence of ME-1 increased with income decile, the reverse was observed for ME-2, reflecting higher non-utilization of institutional maternal care and its non-affordability among poorer households. All the households from the poorest decile and 99% from the second poorest decile paid more than 40% of their capacity to pay. Multivariate regression results indicate that antenatal care and delivery care in private facilities increased the chances of ME-1 and ME-2 (P