Catastrophic expenditure due to out-of-pocket health payments and its determinants in Colombian households.
Catastrophic expenditure due to out-of-pocket health payments and its determinants in Colombian households.
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DOI：
10.1186/s12939-016-0472-z
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发表时间：
2016-11-10
影响因子：
4.8
通讯作者：
Amaya-Lara JL
中科院分区：
文献类型：
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作者：
Amaya-Lara JL
自付医疗服务费用可能导致财政灾难。本研究的目的是确定哥伦比亚医疗保健灾难性自付费用的发生率和决定因素。基本假设是，哥伦比亚的低收入和无保险人口，以及生活在偏远和高度农村地区的家庭，更有可能产生灾难性的医疗费用。这项研究使用了2011年在哥伦比亚进行的全国生活质量调查的数据。灾难性医疗支出的存在是使用世界卫生组织2005年提出的方法计算的。当家庭的自付医疗费用超过其支付能力的20%时，家庭就被归类为具有灾难性医疗支出。所有其他家庭都被归类为没有灾难性的医疗支出。一个概率单位模型估计，旨在确定哪些因素影响灾难性的医疗支出的概率。研究结果表明，9.6%的哥伦比亚家庭有灾难性的支出。在Pacífica和Pacántica地区的家庭、大家庭和核心家庭、有儿童或老年人的家庭、位于农村地区以及没有医疗保健系统保险的家庭中，发病率较高。家庭成员的工作比例似乎可以降低灾难性医疗支出的风险，但任何住院事件的发生都会增加这种风险。因此，没有统计学证据可以否定所研究的假设。结果表明，建立干预机制，以改善公平的获得和支付医疗保健，保护弱势群体免受金融风险，从而减少灾难性的医疗支出的发生率的重要性。为此，必须通过为弱势年龄组提供标准化和更好的保健服务一揽子计划，实现全民健康覆盖，并在自付费用发生率较高的农村地区家庭开展保健运动。
Out-of-pocket expenditure to pay for health services could result in financial catastrophe. The purpose of this study was to identify the incidence and determinants of catastrophic out-of-pocket payments for healthcare in Colombia. The underlying hypotheses are that low-income and non-insured population in Colombia, and households living in isolated and high level of rurality regions, are more likely to incur catastrophic healthcare expenses. This study used data from the Quality of Life National Survey conducted in Colombia in 2011. The presence of catastrophic healthcare spending was calculated using the methodology proposed by the World Health Organization in 2005. Households were classified as having catastrophic health spending when their out-of-pocket health payments were over 20 % of their payment capacity. All other households were classified as not having catastrophic health spending. A probit model was estimated aimed at determining what factors influence the probability of catastrophic healthcare spending. Study findings show that 9.6 % of Colombian households had catastrophic expenditure. The incidence was higher in households in the Pacífica and Atlántica regions, extended and nuclear families, households with children or elderly adults, located in rural areas, and not insured under the healthcare system. The ratio of household members who work seems to reduce the risk of catastrophic healthcare spending, but the occurrence of any in-patient event increases it. So, there is no statistical evidence for rejecting the hypotheses under study. Results indicate the importance of establishing intervention mechanisms in order to improve equity in access and payment for health care, protect vulnerable groups against financial risk, and, consequently, reduce the incidence of catastrophic healthcare spending. For this, it is essential to achieve universal health coverage through standardized and improved health services packages for vulnerable age groups and implement healthcare campaigns for households in rural areas where the incidence of out-of-pocket payments is higher.
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影响因子：
2.1
作者：
Ruiz, Fernando;Amaya, Liliana;Venegas, Stella
通讯作者：
Venegas, Stella
DOI：
10.2471/blt.06.033720
发表时间：
2007-08-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Limwattananon, Supon;Tangcharoensathien, Viroj;Prakongsai, Phusit
通讯作者：
Prakongsai, Phusit
影响因子：
4.8
作者：
Buigut S;Ettarh R;Amendah DD
通讯作者：
Amendah DD
影响因子：
9.7
作者：
Giedion, Ursula;Uribe, Manuela Villar
通讯作者：
Uribe, Manuela Villar
DOI：
10.1007/s10754-011-9089-3
发表时间：
2011-06-01
期刊：
INTERNATIONAL JOURNAL OF HEALTH CARE FINANCE & ECONOMICS
影响因子：
--
作者：
Amaya Lara, Jeannette Liliana;Gomez, Fernando Ruiz
通讯作者：
Gomez, Fernando Ruiz