Catastrophic healthcare expenditure and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia
Catastrophic healthcare expenditure and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia
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DOI：
10.1186/s12889-020-09137-y
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发表时间：
2020-06-22
影响因子：
4.5
通讯作者：
Fenta, Teferi Gedif
中科院分区：
文献类型：
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作者：
Kasahun, Gebremicheal Gebreslassie;Gebretekle, Gebremedhin Beedemariam;Fenta, Teferi Gedif
背景随着癌症的严重程度和死亡率的迅速增加，这是一种管理成本高昂的疾病，一些患者特别是发展中国家的患者正面临着巨大的经济负担。该研究旨在研究灾难性卫生支出（CHE）的发生率，确定相关因素和应对策略，参加癌症治疗服务的患者在阿迪斯，Ethiopia.MethodsA医院为基础的横断面调查癌症患者在公立和私立医院之间进行了1月至2018年3月。使用结构化问卷收集数据。所有直接的医疗和非医疗支出均按每名患者的支出（美元）计量和报告（1美元相当于23.41埃塞俄比亚比尔）。CHE估计使用的阈值为10%的家庭年收入。ResultsA共352（响应率为87.1%）的参与者进行了采访。大部分受访者（73.3%）为女性;大部分（94%）来自公立医院，平均年龄为48 +/-13.2岁。绝大多数（74.4%）患者发生CHE，平均总支出为每例患者2366美元（中位数：1708美元）。医疗支出占总支出的83.6%，平均医疗和非医疗费用分别为1978美元（中位数：1394美元）和388美元（中位数：222美元）。化疗超过6个周期的患者（AOR：3.64; 95% CI：1.11-11.92）和年龄（AOR：1.03; 95% CI：1.01-1.06）与CHE显著相关。家庭储蓄（85.5%）其次是经济支持（43.0%）是主要的应对策略。因此，除了普及已推出的医疗保险计划外，还应考虑其他更好的预付或保险机制，以确保财务风险保障，实现癌症患者的全民健康覆盖。
BackgroundWith the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden. The study aimed to examine the incidence of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.MethodsA hospital-based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.ResultsA total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (SD) age was 48 +/- 13.2years. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure shared the highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support received (43.0%) was the main coping strategy.Conclusion p id=Par A substantial number of patients with cancer were exposed to CHE with a considerable medical expenditure. Hence, in addition to the popularization of the already introduced health insurance scheme, other better prepayment or insurance mechanisms should also be considered to ensure financial risk protection and realize universal health coverage for patients with cancer.