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乌干达金贾地区医疗消费相关的财务风险。

Financial risks associated with healthcare consumption in Jinja, Uganda.

作者信息

Ruhweza M, Baine S O, Onama V, Basaza V, Pariyo G

机构信息

TB Control Assistance Program.

出版信息

Afr Health Sci. 2009 Oct;9 Suppl 2(Suppl 2):S86-9.

Abstract

INTRODUCTION

Financial access to promotive, preventive, curative and rehabilitative healthcare by every one remains a challenge globally. The requirement to make direct payments at the time of consuming health services is one of the reasons why it persists. In this paper, we present findings on the financial risks households bear as a result of healthcare consumption in one district in Uganda.

METHODOLOGY

Using simple random sampling, we selected 384 household heads in 3 health sub districts. A structured questionnaire was to conduct the survey. Focus group discussions and Key Informant interviews were also conducted.

RESULTS

Up to 77% (297/384) of households reported making direct payments for healthcare when a household member fell ill, 45% (174/384) did so each time a household member fell ill. Payment for healthcare was associated with employment of the household head in the informal sector (OR 1.6, 95% 1.2-2.1), presence of children OR 1.5, 95% 1.3-1.9 or someone with chronic illness OR 3, 95% 1.5-6 respectively and history of hospitalization (OR 3, 95% 1.7-6.5).

CONCLUSION

A high burden of healthcare needs, disproportionately affect children and women among households in Jinja. Direct payments for healthcare still occur in spite of the abolishment of user fees at public health facilities and tax based financing of health services in Uganda.

摘要

引言

让每个人都能在经济上获得促进、预防、治疗和康复性医疗保健服务,在全球范围内仍是一项挑战。在消费医疗服务时需要直接付费是这一挑战持续存在的原因之一。在本文中,我们展示了乌干达一个地区家庭因医疗消费而承担的经济风险的调查结果。

方法

我们采用简单随机抽样,在3个卫生分区中选取了384名户主。通过一份结构化问卷进行调查。还开展了焦点小组讨论和关键信息人访谈。

结果

高达77%(297/384)的家庭报告称,家庭成员生病时会直接支付医疗费用,45%(174/384)的家庭每次家庭成员生病时都会这样做。医疗费用支付与户主在非正规部门就业(比值比1.6,95%置信区间1.2 - 2.1)、有孩子(比值比1.5,95%置信区间1.3 - 1.9)或有慢性病患者(比值比3,95%置信区间1.5 - 6)以及有住院史(比值比3,95%置信区间1.7 - 6.5)分别相关。

结论

医疗保健需求负担沉重,对金贾家庭中的儿童和妇女影响尤甚。尽管乌干达已取消公共卫生设施的使用费并采用基于税收的卫生服务筹资方式,但医疗费用的直接支付情况仍然存在。

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