Khammarnia M, Keshtkaran A, Kavosi Z, Hayati R
Bangladesh Med Res Counc Bull. 2014 Aug;40(2):58-62. doi: 10.3329/bmrcb.v40i2.25184.
The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071 ± 0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p < 0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p < 0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.
本研究旨在调查2012年设拉子地区家庭因医疗费用而陷入贫困的情况。在这项家庭调查中，对设拉子地区的800户家庭进行了研究。研究样本分别采用分层抽样和整群抽样的方法在城市和农村地区选取。信息通过世界卫生调查问卷调查的家庭部分进行收集。为了确定因医疗支出导致的贫困，首先测量家庭基于食物的贫困线（维持生计支出）。然后，从家庭总支出中减去家庭医疗支出，如果得到的值低于家庭基于食物的贫困线，则该家庭被认为因医疗支出而陷入贫困。收集到的数据输入到SPSS（版本16）统计软件中，并使用描述性统计、卡方检验和向后法逻辑回归进行分析。研究结果表明，7.1%的家庭（置信区间：0.071±0.018）因医疗支出而陷入贫困。此外，与其他五分位数的家庭相比，第一五分位数的家庭更有可能面临贫困（p<0.05）。参加医疗保险对因医疗费用导致的贫困保护没有影响。此外，居住在农村地区的参与者比居住在城市地区的参与者面临更多贫困（p<0.05）。看来医疗支出可能对设拉子地区的家庭造成经济冲击，家庭可能因医疗支出而陷入贫困。由于保险对贫困没有影响，这意味着医疗保险计划和医疗融资方式的改变是必要的。
