Household costs and care seeking patterns associated with COVID-19 in Blantyre, Malawi.
Household costs and care seeking patterns associated with COVID-19 in Blantyre, Malawi.
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DOI：
10.1371/journal.pgph.0002003
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发表时间：
2023
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COVID-19疾病和医疗保健使用对低收入国家家庭的经济后果尚不清楚。我们从家庭角度估计了与COVID-19寻求护理和治疗相关的成本，并评估了治疗成本的决定因素。2020年12月至2021年11月期间，在布兰太尔区的城市和城郊地区进行了横断面住户调查。确诊COVID-19的成年人（年龄≥18岁）被要求报告他们经历的症状或促使他们寻求COVID-19检测以及COVID-19诊断前后的就医行为。对于寻求医疗保健的个人，收集了患者及其监护人在寻求和接受护理时发生的自付支出信息，包括交通、食品等。最后，时间使用寻求，接受护理和康复期间的数据进行了记录。多变量广义线性模型用于评估家庭COVID-19成本及其决定因素之间的关联。在171名参与研究的人中，平均年龄为40.7岁，标准差（SD）为15.0，50.8%为女性。大多数参与者（85.3%）有症状。其中，67.8%的人到卫生机构寻求治疗，大多数人（91.7%）在门诊接受治疗。与COVID-19寻求、接受护理和康复相关的平均家庭总成本为62.81美元（126.02 SD $）。门诊和住院病例的平均费用分别为52.96美元（SD $54.35）和172.39美元（SD $407.08）。平均自付家庭支出为42.62美元（123.10 SD $），占家庭总成本的62%。作为一名男性COVID-19患者和从事正式工作与高COVID-19家庭成本显著相关。家庭面临与COVID-19疾病和医疗保健使用相关的沉重经济负担。我们需要社会政策支持家庭科普COVID-19的直接和间接成本，以确保获得医疗保健并保护家庭免受COVID-19相关冲击。
Economic consequences of COVID-19 illness and healthcare use for households in low income countries are not well known. We estimated costs associated with COVID-19 care-seeking and treatment from a household perspective and assessed determinants of treatment costs. A cross-sectional household survey was conducted between December 2020 and November 2021 in urban and peri-urban areas of Blantyre district. Adults (age ≥18 years) with confirmed COVID-19 were asked to report the symptoms they experienced or prompted them to seek COVID-19 tests as well as healthcare seeking behaviors preceding and following COVID-19 diagnosis. For individuals who sought healthcare, information on out-of-pocket expenditures incurred while seeking and receiving care including on transport, food etc. by both the patients and their guardians was collected. Finally, data on time use seeking, receiving care and during convalesces was recorded. Multivariate Generalized Linear Models were used to evaluate association between household COVID-19 costs and their determinants. Of 171 individuals who took part in the study, the average age was 40.7 years, standard deviation (SD) 15.0, and 50.8% were females. Most participants (85.3%) were symptomatic. Of these, 67.8% sought care at health facilities and the majority (91.7%) were treated as outpatients. The average total household cost associated with COVID-19 seeking, receiving care and convalescence was $62.81 (SD $126.02). Average costs for outpatient and inpatient cases were $52.96 (SD $54.35) and $172.39 (SD $407.08), respectively. Average out-of-pocket household expenditures were $42.62 (SD $123.10), accounting for 62% of total household costs. Being a male COVID-19 patient and engagement in formal employment were significantly associated with high COVID-19 household costs. Households face high economic burden related to COVID-19 sickness and healthcare use. Social policies that support households cope with both the direct and indirect COVID-19 cost are needed to ensure access to healthcare and protect households from COVID-19 related shocks.