Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria
Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria
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DOI：
10.1371/journal.pone.0040811
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发表时间：
2012-07-16
期刊：
影响因子：
3.7
通讯作者：
Uzochukwu, Benjamin
中科院分区：
文献类型：
--
作者：
Onwujekwe, Obinna;Hanson, Kara;Uzochukwu, Benjamin
目的：关于尼日利亚和许多撒哈拉以南非洲国家灾难性卫生支出的社会经济和其他方面的差异程度，证据有限。该研究估计了灾难性的医疗保健支出水平不同的医疗服务和设施，其分布在社会经济地位（SES）groups.Methods：这项研究发生在四个地方政府地区在东南部尼日利亚。数据收集使用访问者管理的问卷调查管理4873户。灾难性卫生支出（CHE）的衡量标准是每月非食品支出的40%。我们研究了每月总的卫生支出和分类支出的来源和类型的care.Results：平均每月家庭总卫生支出为2354奈拉（19.6美元）。门诊服务的平均月支出为1 809奈拉（15.1美元），住院服务的平均月支出为610奈拉（5.1美元）。城市居民和经济社会地位较好的群体的卫生支出较高。总体而言，27%的家庭发生了CHE，较贫困的社会经济群体和农村居民的比例更高。只有1.0%的家庭有一个成员，参加了健康保险schema.Conclusion：最差的家庭（最贫穷的社会经济地位和农村居民）经历了最高的负担的卫生支出。几乎完全缺乏金融风险保护。需要建立卫生改革机制，以确保金融风险保护机制的普遍覆盖。
Objective: There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups.Methods: The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care.Results: The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme.Conclusion: The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms.