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out-of-pocket payments and economic consequences from tuberculosis care in eastern China:income inequality

Infectious Diseases of Poverty 2020年第1期9卷 26-35页

作者： Yan Liu Cai-Hong Xu Xiao-Mo Wang Zhen-Yu Wang Yan-Hong Wang Hui Zhang Li Wang Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijing 100005China Department of Critical Care Medicine The Second People’s Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhen 518035China National Center for Tuberculosis Control and Prevention China Center for Disease ControlBeijing 100226China

Background:Despite the availability of free tuberculosis(TB)diagnosis and treatment,TB care still generates substantial costs that push people into *** investigated out-of-pocket(OOP)payments for TB care and assessed the resulting economic burden and economic consequences for those with varying levels of household income in eastern ***:A cross-sectional study was conducted among TB patients in the national TB programme networks in eastern ***-related direct OOP costs,time loss,and coping strategies were investigated across households in different economic *** of Variance was used to examine the differences in various costs,and Kruskal-Wallis tests were used to compare the difference in total costs as a percentage of annual household ***:Among 435 patients,the mean OOP total costs of TB care were USD *** the lower-income quartile,OOP payments were lower,but costs as a percentage of reported annual household income were *** costs and costs prior to treatment accounted for 66.4 and 48.9%of the total costs,*** lower the household income was,the higher the proportion of medical costs to total costs before TB treatment,but the lower the proportion of medical costs patients spent in the intensive *** care caused 25.8%of TB-affected households to fall below the poverty line and caused the poverty gap(PG)to increase by United States Dollar(USD)*** in the poorest households had the highest poverty headcount ratio(70.2%)and PG(USD 236.1),but those in moderately poor households had the largest increase in the poverty headcount ratio(36.2%)and PG(USD 177.8)due to TB *** from poor households were more likely to borrow money to cope with the costs of TB care;however,there were fewer social consequences,except for food insecurity,in poor ***:Medical and pretreatment costs lead to high costs of TB care,especially among patients from the poorest *** is nec

关键词： out-of-pocket payment Tuberculosis Impoverishment Coping strategy Eastern China

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Economic costs of hospitalized diarrheal disease in Bangladesh:a societal perspective

引用

Global Health Research and Policy 2018年第1期3卷 377-388页

作者： Abdur Razzaque Sarker Marufa Sultana Rashidul Alam Mahumud Nausad Ali Tanvir M Huda M.Salim uzzaman Sabbir Haider Hafizur Rahman Ziaul Islam Jahangir A.M.Khan Robert Van Der Meer Alec Morton International Centre for Diarrhoeal Disease Research Bangladesh(icddrb)DhakaBangladesh University of Strathclyde GlasgowUK Sydney School of Public Health Sydney Medical SchoolThe University of SydneySydneyAustralia Institute of Epidemiology Disease Control and ResearchDhakaBangladesh Health Economics Unit Ministry of Health and Family WelfareDhakaBangladesh Liverpool School of Tropical Medicine LiverpoolUK

Background:Diarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality *** the burden of the diarrheal diseases is much lower in developed countries,it is a significant public health problem in low and middle-income countries like *** diarrhea is preventable and managed with low-cost interventions,it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those *** aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal ***:This study was conducted in six randomly selected district hospitals from six divisions(larger administrative units)in *** study was performed from the societal perspective which means all types of costs were identified,measured and valued no matter who incurred *** analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal *** study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires,observation checklists,analysis of hospital database,telephone interviews and compilation of service ***:The average total societal cost of illness per episode was BDT 5274.02(US$67.18)whereas the average inpatient and outpatient costs were BDT 8675.09(US$110.51)and BDT 1853.96(US$23.62)*** cost burden was significantly highest for poorest households,21.45%of household income,compared to 4.21%of the richest ***:Diarrheal diseases continue to be an overwhelming problem in *** economic impact of any public health interventions(either preventive or promotive)that can reduce the prevalence

关键词： Bangladesh Catastrophic expenditure Cost-of-illness Diarrhea out-of-pocket payment Public hospitals

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