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尼日利亚灾难性卫生支出的决定因素。

Determinants of catastrophic health expenditure in Nigeria.

机构信息

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Mushin, Lagos, Nigeria.

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

出版信息

Eur J Health Econ. 2018 May;19(4):521-532. doi: 10.1007/s10198-017-0899-1. Epub 2017 May 29.

Abstract

BACKGROUND

Catastrophic health expenditure is a measure of financial risk protection and it is often incurred by households who have to pay out of pocket for health care services that are not affordable. The study assessed the determinants of catastrophic health expenditure among households in Nigeria.

METHODS

Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors associated with catastrophic health expenditure in Nigeria. Household and individual characteristics associated with catastrophic health expenditure were determined using bivariate analysis and multivariate logistic regression.

RESULTS

Results showed that irrespective of the threshold for the two concepts of total household expenditure and non-food expenditure, having household members aged between 6 and 14 years, having household members aged between 15 and 24 years, having household members aged between 25 and 54 years, having no education, having primary education, having secondary education, lack of health insurance coverage, visiting a private health facility, households living in north central zone, households living in north east zone and having household members with non-chronic illnesses were factors that increase the risk of incurring catastrophic health expenditure among households.

CONCLUSIONS

Policy-makers and political actors need to design equitable health financing policies that will increase financial risk protection for people in both the formal and informal sectors of the economy.

摘要

背景

灾难性卫生支出是衡量财务风险保护的一个指标,通常是那些不得不自掏腰包支付无法负担的医疗保健费用的家庭所产生的。本研究评估了尼日利亚家庭发生灾难性卫生支出的决定因素。

方法

利用 2009/10 年的“协调版尼日利亚生活水平调查”(HNLSS)中的二次数据,评估了与尼日利亚灾难性卫生支出相关的因素。使用双变量分析和多变量逻辑回归确定了与灾难性卫生支出相关的家庭和个体特征。

结果

结果表明,无论总家庭支出和非食品支出这两个概念的阈值如何,有 6 至 14 岁、15 至 24 岁、25 至 54 岁的家庭成员、没有教育、接受过小学教育、接受过中学教育、没有医疗保险、去私人医疗机构就诊、居住在中北部地区、居住在东北部地区以及有非慢性疾病成员的家庭,都会增加家庭发生灾难性卫生支出的风险。

结论

决策者和政治行为者需要设计公平的卫生筹资政策,为经济正规和非正规部门的人们提供更多的财务风险保护。

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