Associate Professor, Department of Community Medicine, S.N. Medical College, Agra, Uttar Pradesh, India.
Resident, Department of Community Medicine, S.N. Medical College, Agra, Uttar Pradesh, India.
Indian J Public Health. 2020 Jan-Mar;64(1):60-65. doi: 10.4103/ijph.IJPH_164_19.
Neonatal health remains a thrust area of public health, and an increased out-of-pocket expenditure (OOPE) may hamper efforts toward universal health coverage. Public spending on health remains low and insurance schemes few, thereby forcing impoverishment upon individuals already close to poverty line.
To determine catastrophic health expenditure (CHE) in neonates admitted to the government neonatal intensive care unit (NICU) and factors associated with of out-of-pocket expenditure.
This cross-sectional study was conducted in a governmental NICU at Agra from May 2017 to April 2018. A sample of 450 neonatal admissions was studied. Respondents were interviewed for required data. OOPE included costs at NICU, intervening health facilities, and transport as well. SPSS version (23.0 Trial) and Epi Info were used for analysis.
Of the 450 neonates analyzed, the median total OOPE was Rs. 3000. CHE was found among 55.8% of cases with 22% spending more than their household monthly income. On binary logistic regression, a higher total OOPE of Rs. 3000 or more was found to be significantly associated with higher odds of residing outside Agra (adjusted odds ratio [AOR] = 1.829), delay in first cry (AOR = 1.623), referral points ≥3 (AOR = 3.449), private sector as first referral (AOR = 2.476), and when treatment was accorded during transport (AOR = 1.972).
OOPE on neonates amounts to a substantial figure and is more than the country average. This needs to be addressed sufficiently and comprehensively through government schemes, private enterprises, and public-private partnerships.
新生儿健康仍然是公共卫生的重点领域，而自付支出（OOPE）的增加可能会阻碍全民健康覆盖的努力。公共卫生支出仍然很低，保险计划也很少，这使得已经接近贫困线的个人陷入贫困。
确定入住政府新生儿重症监护病房（NICU）的新生儿的灾难性卫生支出（CHE）以及与自付支出相关的因素。
本横断面研究于 2017 年 5 月至 2018 年 4 月在阿格拉的一家政府 NICU 进行。研究了 450 名新生儿入院的样本。对受访者进行了所需数据的访谈。OOPE 包括 NICU、干预性卫生机构和运输费用。使用 SPSS 版本（23.0 试用版）和 Epi Info 进行分析。
在分析的 450 名新生儿中，中位数总 OOPE 为 3000 卢比。发现 55.8%的病例存在 CHE，其中 22%的病例支出超过其家庭月收入。在二元逻辑回归中，发现总 OOPE 为 3000 卢比或更多与更高的 Odds 显著相关，即居住在阿格拉以外（调整后的 Odds 比 [AOR] = 1.829）、首次哭泣延迟（AOR = 1.623）、转诊点≥3（AOR = 3.449）、私营部门作为第一转诊（AOR = 2.476），以及在运输过程中接受治疗（AOR = 1.972）。
新生儿的 OOPE 数额相当大，超过了全国平均水平。这需要通过政府计划、私营企业和公私伙伴关系来充分和全面地解决。
