Sadoh W E, Nwaneri D U, Owobu A C
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Niger J Clin Pract. 2011 Jan-Mar;14(1):65-9. doi: 10.4103/1119-3077.79255.
To evaluated the economic burden to families of managing chronic heart failure in children with congenital heart disease.
This longitudinal study was conducted over a year. The families of children with congenital heart disease who were being managed for chronic heart failure in the clinic were recruited for the study. With the aid of a structured questionnaire, data were collected on a monthly basis for three consecutive months, on the family's monthly income, cost of anti-failure medicines, transportation and the number of man-hours spent on clinic visitation. The percentage of the mean monthly income spent on medicines, transportation and the total cost of care were also computed.
Thirty two families were recruited for the study. The children were 16(50%) each of males and females with a mean age of 2.2 ± 1.7 years. The mean monthly income was $314.93 ± 271.36 while the mean cost of total care was $17.61 ± 10.58. The mean percentage of income spent on total care was 16.3 ± 26.2 % with a range of 0.7 - 122%. Families from low socioeconomic class spent significantly higher percentage of income on medicines and total care compared to those in middle or high socioeconomic classes, P = 0.0095 and 0.041 respectively. Only three (0.09%) patients had surgery for their condition.
The mean percentage of income spent on care was significant and amounted to catastrophic health expenditure for a third of the families. Government input in strengthening the existing cardiac centres, establish new ones and subsidising the cost of surgery to meet the needs for open heart surgery for children with CHDs is recommended.
评估先天性心脏病患儿慢性心力衰竭家庭管理的经济负担。
本纵向研究为期一年。招募了在诊所接受慢性心力衰竭治疗的先天性心脏病患儿家庭参与研究。借助结构化问卷，连续三个月每月收集数据，内容包括家庭月收入、抗心衰药物费用、交通费用以及门诊就诊花费的工时数。还计算了月均收入用于药物、交通及总护理费用的百分比。
32个家庭参与了研究。患儿中男性和女性各16名（各占50%），平均年龄为2.2±1.7岁。月均收入为314.93美元±271.36美元，而总护理费用平均为17.61美元±10.58美元。总护理费用占收入的平均百分比为16.3±26.2%，范围在0.7 - 122%之间。与社会经济地位中等或高等的家庭相比，社会经济地位低的家庭在药物和总护理方面花费的收入百分比显著更高，P值分别为0.0095和0.041。只有3名（0.09%）患者接受了针对其病情的手术。
护理费用占收入的平均百分比很高，对三分之一的家庭来说相当于灾难性医疗支出。建议政府加大投入，加强现有心脏中心建设，建立新的心脏中心，并补贴手术费用，以满足先天性心脏病患儿心脏直视手术的需求。
