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缅甸患者寻求疟疾治疗的费用。

Costs to the patient for seeking malaria care in Myanmar.

作者信息

Gatton M L

机构信息

Malaria Biology Unit, Queensland Institute of Medical Research, Royal Brisbane Hospital PO, Brisbane 4029, Qld., Australia.

出版信息

Acta Trop. 2004 Nov-Dec;92(3):173-7. doi: 10.1016/j.actatropica.2003.12.005.

Abstract

This study investigates the costs incurred by patients diagnosed with uncomplicated malaria at a formal rural health facility in Myanmar. A cross-sectional survey of 410 patients indicated that the majority of patients were male (89.3%), married (84.6%) and the head of their family (80.2%); this spectrum reflected the deliberate selection of persons for whom relatively accurate costing was feasible. The average total costs incurred for an episode of malaria was kyats 173.58 (95% CI = 166.13-181.02). with the highest cost contribution being the loss of earnings due to absence from work (mean = kyats 135.05; 95% CI = 128.14-141.96). Total costs to the patient per episode were, on the average, equivalent to 4.2 days of per capita economic output indicating that malaria imposes a significant financial burden on the patient even though medical services and treatment are provided free of charge. Variables significantly positively associated with patient cost included the duration of illness (P < 0.001), income of the patient (P < 0.001), presence of accompanying person at the health facility (P < 0.001) and being a farmer (P = 0.026). The results of this study highlight the importance of using confirmatory diagnosis in rural settings to minimize the financial burden of malaria to the patient and family.

摘要

本研究调查了在缅甸一家正规农村卫生机构被诊断为单纯性疟疾的患者所产生的费用。对410名患者进行的横断面调查表明,大多数患者为男性(89.3%)、已婚(84.6%)且是家庭户主(80.2%);这一群体反映了为相对准确计算成本可行的人群的刻意选择。疟疾发作的平均总费用为173.58缅元(95%置信区间 = 166.13 - 181.02),其中成本贡献最高的是因缺勤导致的收入损失(均值 = 135.05缅元;95%置信区间 = 128.14 - 141.96)。每次发作患者的平均总成本相当于人均经济产出的4.2天,这表明即使医疗服务和治疗是免费提供的,疟疾仍给患者带来了巨大的经济负担。与患者成本显著正相关的变量包括疾病持续时间(P < 0.001)、患者收入(P < 0.001)、在卫生机构有陪同人员(P < 0.001)以及为农民(P = 0.026)。本研究结果凸显了在农村地区使用确诊诊断以尽量减少疟疾给患者和家庭带来的经济负担的重要性。

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