Falling into the medical poverty trap in Sri Lanka: What can be done?
Falling into the medical poverty trap in Sri Lanka: What can be done?
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DOI：
10.2190/4635-18k0-2371-1843
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发表时间：
2007-01-01
影响因子：
3.4
通讯作者：
Bird, Philippa
中科院分区：
文献类型：
--
作者：
Perera, Myrtle;Gunatilleke, Godfrey;Bird, Philippa
斯里兰卡的公共卫生保健系统在使用点是免费的，并始终注重公平。然而，糖尿病等非传染性疾病的流行率正在迅速上升，给卫生系统以及患者和家庭带来了新的挑战。在斯里兰卡四个地区进行深度访谈和焦点小组讨论，调查来自不同收入水平家庭的糖尿病患者的求医经历。虽然保健是免费的，但其他直接和间接费用阻碍了人们在诊断前后寻求保健，并给家庭带来沉重负担。需要经常前往具有适当诊断和管理糖尿病设施的诊所，这些诊所往往远离农村社区，这造成了高昂的费用，特别是由于失去了收入。家庭采取了应对策略，但频繁的诊所就诊带来了重复的费用，这使得家庭难以恢复其经济地位。许多患者，特别是来自低收入农村家庭的患者，无法维持管理方案，病情恶化。有必要在靠近农村地区的地点建立诊断和管理糖尿病的专门设施。
Sri Lanka's public health care system is free at the point of use and maintains a focus on equity. However, noncommunicable diseases, such as diabetes, are rapidly increasing in prevalence and posing new challenges to the system and to patients and households. In-depth interviews and focus group discussions were conducted in four districts of Sri Lanka to investigate the care-seeking experiences of diabetes patients from households at different income levels. Although health care is free, other direct and indirect costs served as deterrents to care seeking before and after diagnosis, and placed a high burden on households. The need for frequent visits to clinics with appropriate facilities for diagnosis and management of diabetes, often far from rural communities, posed high costs, in particular due to income foregone. Households employed coping strategies, but the need for frequent clinic visits posed repeated costs, which made it difficult for households to recover their economic status. Many patients, especially those from low-income, rural households, could not maintain the management regimen, and their condition deteriorated. There is a need for specialist facilities for the diagnosis and management of diabetes at locations closer to rural areas.