Financial burden of health care for Buruli ulcer patients in Nigeria: the patients' perspective
Financial burden of health care for Buruli ulcer patients in Nigeria: the patients' perspective
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DOI：
10.1093/inthealth/ihw056
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发表时间：
2017-01-01
影响因子：
2.5
通讯作者：
Ukwaja, Kingsley N.
中科院分区：
文献类型：
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作者：
Chukwu, Joseph N.;Meka, Anthony O.;Ukwaja, Kingsley N.
背景：布鲁里溃疡给患者带来的经济负担尚未得到充分记录。本研究评估了患者从发病到诊断到治疗结束的布鲁里溃疡护理费用。方法：这是 2015 年 7 月至 9 月期间在尼日利亚四个州的布鲁里溃疡患者中进行的横断面疾病费用研究。使用结构化问卷收集有关患者特征、家庭收入和自付费用的数据。结果：在接受调查的 92 名患者中，54 名 (59%) 年龄超过 15 岁年中，49 人（53%）为男性，86 人（93%）居住在农村地区。每个患者的直接医疗和非医疗费用中位数 (IQR) 分别为 124 美元 (50-282) 和 3 美元 (3-6)；分别相当于患者家庭月收入中位数的 149% 和 4%。每个患者的总体直接费用为 135 美元（58-327），相当于家庭月收入中位数的 162%，其中预诊断费用占总费用的 94.8%。对于 50% 的患者家庭来说，布鲁里溃疡护理的直接费用是灾难性的 - 对于收入最低和最高四分位数的患者来说，布鲁里溃疡护理的灾难性费用比例分别为 66% 和 19%。结论：布鲁里溃疡诊断和治疗的直接费用对相当一部分患者及其家庭来说是灾难性的。
Background: The economic burden of Buruli ulcer for patients has not been well-documented. This study assessed the costs of Buruli ulcer care to patients from the onset of illness to diagnosis and to the end of treatment.Methods: This was a cross-sectional cost of illness study conducted among patients with Buruli ulcer in four States in Nigeria between July and September 2015. A structured questionnaire was used to collect data on the patients' characteristics, household income and out-of-pocket costs of care.Results: Of 92 patients surveyed, 54 (59%) were older than 15 years, 49 (53%) were males, and 86 (93%) resided in a rural area. The median (IQR) direct medical and non-medical cost per patient was US$ 124 (50-282) and US$ 3 (3-6); corresponding to 149% and 4% of the patients' median monthly household income, respectively. The overall direct costs per patient was US$ 135 (58-327), which corresponded to 162% of median monthly household income, with pre-diagnosis costs accounting for 94.8% of the total costs. The direct costs of Buruli ulcer care were catastrophic for 50% of all patientshouseholds - the rates of catastrophic costs for Buruli ulcer care was 66% and 19% for patients belonging to the lowest and highest income quartiles, respectively.Conclusions: Direct costs of Buruli ulcer diagnosis and treatment are catastrophic to a substantial proportion of patients and their families.