Division of Maternal and Child Health, School of Public Health, Peking University Beijing, Beijing, China.
PLoS One. 2012;7(6):e38467. doi: 10.1371/journal.pone.0038467. Epub 2012 Jun 6.
To identify the immediate economic impact of maternal death on rural Chinese households.
Results are reported from a study that matched 195 households who had suffered a maternal death to 384 households that experienced a childbirth without maternal death in rural areas of three provinces in China, using quantitative questionnaire to compare differences of direct and indirect costs between two groups.
The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001). More than 40% of the direct costs were attributed to funeral expenses. Hospitalization and emergency care expenses were the largest proportion of non-funeral direct costs and were higher in households with maternal death than the comparison group (US$2,248 vs. $305, p<0.001). To cover most of the high direct costs, 44.1% of affected households utilized compensation from hospitals, and the rest affected households (55.9%) utilized borrowing money or taking loans as major source of money to offset direct costs. The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.
The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.
识别孕产妇死亡对中国农村家庭的直接经济影响。
本研究通过定量问卷调查比较了三组农村家庭的直接和间接成本差异,结果报告了在中国三个省份的农村地区,对 195 户发生孕产妇死亡的家庭和 384 户未发生孕产妇死亡的家庭进行匹配的结果。
孕产妇死亡的直接成本明显高于无孕产妇死亡的分娩成本(4119 美元 vs. 370 美元,p<0.001)。超过 40%的直接成本归因于丧葬费。住院和急救费用是非丧葬费直接成本中最大的一部分,且孕产妇死亡家庭的这部分费用高于对照组(2248 美元 vs. 305 美元,p<0.001)。为了支付大部分高额直接成本,44.1%的受影响家庭利用医院的赔偿,其余受影响家庭(55.9%)利用借款或贷款作为主要资金来源来抵消直接成本。孕产妇死亡的直接(和未报销)成本的经济负担中位数相当高——占家庭年收入的 37.0%,约为支出被认为是灾难性的门槛的 4 倍。
孕产妇死亡对研究的三省农村家庭的直接经济负担是极其灾难性的。