Attanayake N, Fox-Rushby J, Mills A
Health Economics Study Programme, Department of Economics, University of Colombo, Colombo, Sri Lanka.
Trop Med Int Health. 2000 Sep;5(9):595-606. doi: 10.1046/j.1365-3156.2000.00612.x.
Short-run economic consequences of 'malaria' on households were examined in a household survey in Matale, a malaria-endemic district of Sri Lanka. On average a household incurred a total cost of Rs 318 (US$ 7) per patient who fully recovered from 'malaria'. 24% of this was direct cost, 44% indirect cost for the patient and 32% indirect cost for the household. Direct costs were greater for those seeking treatment in the private sector. Notably a large proportion of direct costs was spent on complementary goods such as vitamins and foods considered to be nutritional. Indirect cost was measured and valued on the basis of output/ income losses incurred at the household level rather than using a general indicator such as average wage rate. Loss of output and wages accounted for the highest proportion of the indirect cost of the patients as well as the households. Relative to children, more young adults and middle-aged people had 'malaria' which also caused greater economic loss in these age groups. Women tended to care for patients rather than substitute their labour to cover productive work lost due to illness. We compare the methods used by other researchers for valuing indirect cost, demonstrating the significant impact that methods of measurement and valuation can have on the estimation of indirect cost, and justify the recommendation for methodological research in this area.
在斯里兰卡疟疾流行区马特勒进行的一项家庭调查中，研究了“疟疾”对家庭的短期经济影响。平均而言，每位从“疟疾”中完全康复的患者，家庭总共花费318卢比（7美元）。其中24%为直接成本，44%为患者的间接成本，32%为家庭的间接成本。在私营部门寻求治疗的患者，直接成本更高。值得注意的是，很大一部分直接成本花在了补充品上，如维生素和被认为有营养的食物。间接成本是根据家庭层面产生的产出/收入损失来衡量和估值的，而不是使用诸如平均工资率这样的一般指标。产出和工资损失在患者以及家庭的间接成本中占比最高。相对于儿童，更多的年轻人和中年人患“疟疾”，这也在这些年龄组中造成了更大的经济损失。女性往往倾向于照顾患者，而不是替代他们的劳动力来弥补因疾病而损失的生产性工作。我们比较了其他研究人员用于评估间接成本的方法，证明了测量和估值方法对间接成本估计可能产生的重大影响，并说明了在该领域进行方法学研究的建议的合理性。
