Rocha-García Arnoldo, Hernández-Peña Patricia, Ruiz-Velazco Silvia, Avila-Burgos Leticia, Marín-Palomares Teresa, Lazcano-Ponce Eduardo
Instituto Mexicano del Seguro Social (IMSS), León, Guanajuato, México.
Salud Publica Mex. 2003 Jul-Aug;45(4):285-92.
To estimate out-of-pocket expenditures for health care during the first hospitalization of children treated for leukemia in two hospitals of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS-).
A cross-sectional study was conducted in Mexico City and Leon, Guanajato, Mexico in 1997. The study population consisted of the parents of 51 children under 15 years of age diagnosed with leukemia, who were hospitalized for the first time in two IMSS hospitals. A questionnaire was applied to participants to obtain direct and indirect expenditures during that period. Consumer price indexes (1997-2002) were used to estimate expenditure prices for 2002. Average expenditures and catastrophic expenditures were estimated. Factors associated with expenditures were analyzed using a linear regression model in which the dependent variable was the total household expenditures during hospitalization.
The average household cost per hospitalization was 7,318 pesos, 86% of which corresponded to medical care and 14% to indirect costs. Catastrophic expenditures occurred in 14% of households. In 47% of household expenditures exceeded 100% of the total household income during the hospitalization period. Expenditures during hospitalization were associated with place of residence, income level, and type of medical insurance.
Being an IMSS policyholder decreased out-of-pocket expenditures, but not complementary expenditures, which may still be unaffordable for a large segment of the population. For more than a half of the households studied, continuity of care was compromised, as expenditures during the first hospitalization entailed using up savings, going into debt, and/or selling household property.
估算墨西哥社会保障局（墨西哥社会保障协会 - IMSS - ）两家医院收治的白血病患儿首次住院期间的自付医疗费用。
1997年在墨西哥城和瓜纳华托州莱昂市开展了一项横断面研究。研究人群包括51名15岁以下被诊断为白血病且首次在两家IMSS医院住院的患儿的父母。向参与者发放问卷以获取该期间的直接和间接费用。使用消费价格指数（1997 - 2002年）估算2002年的支出价格。估算平均支出和灾难性支出。使用线性回归模型分析与支出相关的因素，其中因变量是住院期间家庭总支出。
每次住院的家庭平均费用为7318比索，其中86%为医疗费用，14%为间接费用。14%的家庭出现了灾难性支出。47%的家庭在住院期间支出超过家庭总收入的100%。住院期间的支出与居住地点、收入水平和医疗保险类型有关。
作为IMSS的投保人可降低自付费用，但不能降低补充费用，而补充费用对很大一部分人群来说可能仍然难以承受。对于超过一半的研究家庭来说，由于首次住院期间的支出导致储蓄耗尽、负债和/或变卖家庭财产，医疗连续性受到了影响。
