Catastrophic health care spending and impoverishment in Kenya.
Catastrophic health care spending and impoverishment in Kenya.
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DOI：
10.1186/1472-6963-12-413
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发表时间：
2012-11-21
影响因子：
2.8
通讯作者：
Maina T
中科院分区：
文献类型：
--
作者：
Chuma J;Maina T
非洲许多卫生系统的资金主要来自自付。自费支付妨碍人们寻求医疗服务，可能导致灾难性的卫生支出并导致贫困。本文估计了肯尼亚自付医疗费用的负担；灾难性卫生保健支出的发生率和强度以及卫生支出对国家贫困估计的影响。数据来自2007年进行的具有全国代表性的卫生支出和利用调查（n = 8414）。该调查提供了关于自费付款和消费支出的详细信息。采用标准数据分析技术来估计灾难性卫生支出的发生率和强度。采用不同的阈值来证明灾难性措施的敏感性。每年，肯尼亚家庭将超过十分之一的预算用于支付医疗费用。穷人的自付负担最重。最贫穷的家庭每年将其资源的三分之一用于医疗保健支付，而最富有的家庭仅为8%。大约有148万肯尼亚人由于医疗费用而被推到国家贫困线以下。由于医疗保健费用，肯尼亚人正变得越来越穷。为了保护个人免受与卫生保健有关的贫困，需要对肯尼亚卫生系统进行紧急改革。一个重要的政策问题仍然是，肯尼亚需要进行何种卫生系统改革，以确保实现对所有人的财务风险保护。
Many health systems in Africa are funded primarily through out-of-pocket payments. Out-of-pocket payments prevent people from seeking care, can result to catastrophic health spending and lead to impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and the effect of health spending on national poverty estimates. Data were drawn from a nationally representative health expenditure and utilization survey (n = 8414) conducted in 2007. The survey provided detailed information on out-of-pocket payments and consumption expenditure. Standard data analytical techniques were applied to estimate the incidence and intensity of catastrophic health expenditure. Various thresholds were applied to demonstrate the sensitivity of catastrophic measures. Each year, Kenyan households spend over a tenth of their budget on health care payments. The burden of out-of-pocket payments is highest among the poor. The poorest households spent a third of their resources on health care payments each year compared to only 8% spent by the richest households. About 1.48 million Kenyans are pushed below the national poverty line due to health care payments. Kenyans are becoming poorer due to health care payments. The need to protect individuals from health care related impoverishment calls for urgent reforms in the Kenyan health system. An important policy question remains what health system reforms are needed in Kenya to ensure that financial risk protection for all is achieved.
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影响因子：
3
作者：
Chuma JM;Thiede M;Molyneux CS
通讯作者：
Molyneux CS
影响因子：
2.1
作者：
Pradhan, M;Prescott, N
通讯作者：
Prescott, N
影响因子：
2.1
作者：
Wagstaff, A;van Doorslaer, E
通讯作者：
van Doorslaer, E
影响因子：
2.1
作者：
Van Doorslaer, Eddy;O'Donnell, Owen;Zhao, Yuxin
通讯作者：
Zhao, Yuxin
影响因子：
6.3
作者：
Kakwani, N;Wagstaff, A;vanDoorslaer, E
通讯作者：
vanDoorslaer, E