The financial burden of sickle cell disease on households in Ekiti, Southwest Nigeria
The financial burden of sickle cell disease on households in Ekiti, Southwest Nigeria
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DOI：
10.2147/ceor.s86599
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Aderiye, Odunayo
中科院分区：
文献类型：
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作者：
Olatunya, Oladele Simeon;Ogundare, Ezra Olatunde;Aderiye, Odunayo
背景资料：尽管镰状细胞病（SCD）在发展中国家的儿童中很常见，但对其经济影响的研究却很少。目的：确定尼日利亚西南部Ado埃基蒂的SCD对家庭的经济负担。方法：对埃基蒂州立大学教学医院儿科血液科111例SCD患儿家庭护理支出的纵向和描述性研究结果：2014年1月至12月，共纳入15 ~ 180个月的儿童，男64例，女47例。他们来自111个家庭，其中只有8个（7.2%）参加了国家健康保险计划。每名儿童的入院和门诊人数分别为1至5人和1至10人。疟疾、血管闭塞危象和严重贫血是主要的合并症。家庭月收入介于。12,500和。330，000（76美元和2，000美元），中位数为。55，000（333美元），医疗费用介于两者之间。2,500和。215，000（15美元和1，303美元），平均数（标准行业分类）为39，554 +/-35，479（240美元+/- 215）。63名儿童的父母因其子女的健康状况不佳而损失了1至48个工作日。23个孩子的父母获得了贷款，贷款金额从1.5亿美元到1.5亿美元不等。6,500和。150，000美元（39美元和909美元），用于支付医院费用。家庭收入中用于每个儿童的保健支出的百分比从0.38到34.4不等。23户（20.7%）发生灾难性卫生支出（卫生支出占家庭收入的10%以上）。那些贷款来抵消医院账单的父母，低社会阶层，以及在研究期间生病的病人，有更高的灾难性医疗支出的可能性（95%可信区间[CI] 5.399-87.176，P=0.000; 95%可信区间[CI] 2.322-47.310，P=0.002; 95%可信区间[CI] 1.128-29.694，P=0.035）。
Background: Studies on economic impact of sickle cell disease (SCD) are scanty despite its being common among children in developing countries who are mostly Africans.Objective: To determine the financial burden of SCD on households in Ado Ekiti, Southwest Nigeria.Methods: A longitudinal and descriptive study of household expenditures on care of 111 children with SCD managed at the pediatric hematology unit of the Ekiti State University Teaching Hospital was conducted between January and December 2014.Results: There were 64 male and 47 female children involved, aged between 15 and 180 months. They were from 111 households, out of which only eight (7.2%) were enrolled under the National Health Insurance Scheme. The number of admissions and outpatients' consultations ranged from 1 to 5 and 1 to 10 per child, respectively. Malaria, vaso-occlusive crisis, and severe anemia were the leading comorbidities. The monthly household income ranged between. 12,500 and. 330,000 (US$76 and US$2,000) with a median of. 55,000 (US$333), and health expenditure ranged between. 2,500 and. 215,000 (US$15 and US$1,303) with a mean of (SIC) 39,554 +/- 35,479 (US$ 240 +/- 215). Parents of 63 children lost between 1 and 48 working days due to their children's ill health. Parents of 23 children took loans ranging between. 6,500 and. 150,000 (US$ 39 and US$ 909) to offset hospital bills. The percentage of family income spent as health expenditure on each child ranged from 0.38 to 34.4. Catastrophic health expenditure (when the health expenditure >10% of family income) occurred in 23 (20.7%) households. Parents who took loan to offset hospital bills, low social class, and patients who took ill during the study period significantly had higher odds for catastrophic health expenditure (95% confidence interval [CI] 5.399-87.176, P=0.000; 95% CI 2.322-47.310, P=0.002; and 95% CI 1.128-29.694, P=0.035, respectively).Conclusion: SCD poses enormous financial burden on parents and households.