Household catastrophic health expenditure and its effective factors: a case of Iran.
Household catastrophic health expenditure and its effective factors: a case of Iran.
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DOI：
10.1186/s12962-021-00315-2
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发表时间：
2021-09-16
期刊：
影响因子：
--
通讯作者：
Bastani P
中科院分区：
文献类型：
--
作者：
Ravangard R;Jalali FS;Bayati M;Palmer AJ;Jafari A;Bastani P
世界卫生组织（卫生组织）特别重视保护家庭免受保健支出的影响。许多家庭由于经济贫困和为治疗疾病筹资而面临灾难性的卫生支出。本研究旨在衡量2018年伊朗设拉子面临灾难性CHE的家庭比例以及与CHE发生相关的因素。本横断面研究于2018年使用多阶段抽样方法对伊朗设拉子不同地区的740个随机选择的家庭进行了调查。收集数据时使用的是波斯文版的“世卫组织全球健康调查”问卷。卫生保健支出被定义为超过家庭支付能力40%的卫生保健支出。在支付保健服务之前生活在贫困线以下的家庭被排除在研究之外。在5%的显著性水平下，使用SPSS 23.0中的卡方检验和多元Logistic回归模型确定家庭特征与面临的CHE之间的关联。结果表明，16.48%的被调查家庭面临过社区卫生服务。居住在出租房屋中的家庭面临CHE的几率更高（OR = 3.14，P值< 0.001），有残疾成员的家庭（OR = 27.98，P值< 0.001），有5岁以下儿童的家庭（OR = 2.718，P值= 0.02），无补充医疗保险者（OR = 1.87，P值= 0.01）。通过增加个人和家庭对补充医疗保险的使用，增加社会保障和国家福利组织对有残疾成员的家庭的支持，制定综合儿童保育方案等方案，以及为租户制定房屋租赁政策和住房政策，可以减少社区住房。在线版本包含补充材料，可通过10.1186/s12962-021-00315-2获得。
The World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018. The present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the “WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. Households living below the poverty line before paying for health services were excluded from the study. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modeling in SPSS 23.0 at the significance level of 5%. The results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR = 3.14, P-value < 0.001), households with disabled members (OR = 27.98, P-value < 0.001), households with children under 5 years old (OR = 2.718, P-value = 0.02), and those without supplementary health insurance coverage (OR = 1.87, P-value = 0.01). CHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants. The online version contains supplementary material available at 10.1186/s12962-021-00315-2.
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