Prinja Shankar, Jagnoor Jagnoor, Chauhan Akashdeep Singh, Aggarwal Sameer, Nguyen Ha, Ivers Rebecca
School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
The George Institute for Global Health, University of Sydney 2000, Australia.
Int J Environ Res Public Health. 2016 Jul 2;13(7):673. doi: 10.3390/ijerph13070673.
There is little documentation of the potential catastrophic effects of injuries on families due to out of pocket (OOP) expenditure for medical care. Patients who were admitted for at least one night in a tertiary care hospital of Chandigarh city due to injury were recruited and were followed-up at 1, 2 and 12 months after discharge to collect information on OOP expenditure. Out of the total 227 patients, 60% (137/227) had sustained road traffic injuries (RTI). The average OOP expenditure per hospitalisation and up to 12 months post discharge was USD 388 (95% CI: 332-441) and USD 1046 (95% CI: 871-1221) respectively. Mean OOP expenditure for RTI and non-RTI cases during hospitalisation was USD 400 (95% CI: 344-456) and USD 369 (95% CI: 313-425) respectively. The prevalence of catastrophic expenditure was 30%, and was significantly higher among those belonging to the lowest income quartile (OR-26.50, 95% CI: 6.70-105.07, p-value: <0.01) and with an inpatient stay greater than 7 days (OR-10.60, 95% CI: 4.21-26.64, p-value: <0.01). High OOP expenditure for treatment of injury puts a significant economic burden on families. Measures aimed at increasing public health spending for prevention of injury and providing financial risk protection are urgently required in India.
关于因自付医疗费用而导致伤害给家庭带来潜在灾难性影响的记录很少。招募了因伤在昌迪加尔市一家三级护理医院住院至少一晚的患者，并在出院后1个月、2个月和12个月进行随访，以收集自付费用的信息。在总共227名患者中，60%（137/227）遭受了道路交通伤害（RTI）。每次住院以及出院后长达12个月的平均自付费用分别为388美元（95%置信区间：332 - 441）和1046美元（95%置信区间：871 - 1221）。道路交通伤害和非道路交通伤害病例在住院期间的平均自付费用分别为400美元（95%置信区间：344 - 456）和369美元（95%置信区间：313 - 425）。灾难性支出的患病率为30%，在收入最低四分位数人群（比值比 - 26.50，95%置信区间：6.70 - 105.07，p值：<0.01）以及住院时间超过7天的人群中（比值比 - 10.60，95%置信区间：4.21 - 26.64，p值：<0.01）显著更高。用于治疗伤害的高额自付费用给家庭带来了巨大的经济负担。印度迫切需要采取措施增加公共卫生支出以预防伤害并提供财务风险保护。
