Duraisamy P, Ganesh A K, Homan R, Kumarasamy N, Castle C, Sripriya P, Mahendra V, Solomon S
Department of Econometrics, University of Madras, Chepauk, India.
AIDS Care. 2006 Feb;18(2):121-7. doi: 10.1080/09540120500159359.
The objective of this study is to estimate the medical and non-medical out-of-pocket expenditure on care and support services to PLHA, the financial burden on households, the indirect costs and coping strategies to meet the financial burden. A structured pre-tested questionnaire was used to collect data from a cohort of 153 clients of YRG CARE, a leading Chennai based NGO, who had completed the first and third waves of interview during 2000/01 and 2001/02 respectively. The results show that the median out-of-pocket medical and non-medical expenditures (direct cost) for treatment and services are Rs. 6,000 (US $ 122) in a reference period of six months. Clients on antiretroviral (ARV) drugs spend five times more than those not on ARV. The median direct cost significantly increases with stage of disease, household income, and poverty level. The financial burden of treatment, measured as the ratio of direct cost to household income, is greater on lower income (82%) than on higher income (28%) households. 31% and 45% of the clients reported loss of income and workdays respectively. In conclusion, the direct costs and financial burden of care and support services increase with the stage of disease. The financial burden is disproportionately more on low-income households. HIV/AIDS leads to depletion of savings and increases the indebtedness of households.
本研究的目的是估计艾滋病毒感染者在护理和支持服务方面的医疗和非医疗自付费用、家庭的经济负担、间接成本以及应对经济负担的策略。使用一份经过预测试的结构化问卷，从位于金奈的一家领先非政府组织YRG CARE的153名客户群体中收集数据，这些客户分别在2000/01年和2001/02年完成了第一轮和第三轮访谈。结果显示，在六个月的参考期内，治疗和服务的自付医疗和非医疗支出（直接成本）中位数为6000卢比（122美元）。服用抗逆转录病毒（ARV）药物的客户支出比未服用ARV药物的客户高出五倍。直接成本中位数随疾病阶段、家庭收入和贫困水平显著增加。以直接成本与家庭收入之比衡量的治疗经济负担，低收入家庭（82%）比高收入家庭（28%）更大。分别有31%和45%的客户报告有收入损失和工作日损失。总之，护理和支持服务的直接成本和经济负担随疾病阶段增加。低收入家庭的经济负担不成比例地更大。艾滋病毒/艾滋病导致储蓄耗尽并增加家庭债务。
