Zawudie Addisu Bogale, Lemma Teferi Daba, Daka Dawit Wolde
Pathfinder International Ethiopia, Addis Ababa, Ethiopia.
Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia.
Clinicoecon Outcomes Res. 2020 Apr 9;12:201-211. doi: 10.2147/CEOR.S241591. eCollection 2020.
Hypertension is a common vascular disease and the main risk factor for cardiovascular diseases. Since the incidence of hypertension is rising in Ethiopia, one may expect that the household's cost of healthcare services related to the disease will increase in the near future. Yet the cost associated with the disease is not known. We aimed to estimate the total cost of hypertension illness and identify associated factors among patients attending hospitals in Southwest Shewa zone, Oromia regional state, Ethiopia.
An institution-based cross-sectional study design was employed to conduct the study from 13 August to 2 September 2018. All hypertensive patients aged 18 years and older who were on follow-up were eligible for this study. The total cost of hypertension illness was estimated by summing the direct and indirect costs. Bivariate and multivariate linear regression analyses were performed to identify factors associated with hypertension costs of illnesses.
A total of 349 patients participated in the study. The mean monthly total cost of hypertension illness was US$ 22.3 (95% CI, 21.3-23.3). Direct and indirect costs constitute 51% and 49% of the total cost, respectively. The mean direct cost of hypertension illness per patient per month was US$ 11.39 (95% CI, 10.6-12.1). Out of these, drugs comprised higher cost (31%), followed by food (25%). The mean indirect cost per patient per month was US$ 10.89 (95% CI, 10.4-11.4). In this study, the primary educational status, family size (4-6 and >6), distance from hospital (≥10 km), the presence of a companion and stage of hypertension (stage two) of patients were identified as the predictors of the cost of hypertension illnesses.
The cost of hypertension illness was very high when compared to the monthly income of households, exposing patients to catastrophic costs. Hence, the government should give due attention to protect patients from catastrophic health expenditures.
高血压是一种常见的血管疾病，也是心血管疾病的主要危险因素。由于埃塞俄比亚高血压发病率不断上升，人们可能预计，近期与该疾病相关的家庭医疗保健服务成本将会增加。然而，与该疾病相关的成本尚不清楚。我们旨在估计埃塞俄比亚奥罗米亚州西南舍瓦地区医院就诊患者的高血压疾病总成本，并确定相关因素。
采用基于机构的横断面研究设计，于2018年8月13日至9月2日进行研究。所有年龄在18岁及以上且正在接受随访的高血压患者均符合本研究条件。通过将直接成本和间接成本相加来估计高血压疾病的总成本。进行双变量和多变量线性回归分析，以确定与高血压疾病成本相关的因素。
共有349名患者参与了研究。高血压疾病的月平均总成本为22.3美元（95%置信区间，21.3 - 23.3）。直接成本和间接成本分别占总成本的51%和49%。每位患者每月高血压疾病的平均直接成本为11.39美元（95%置信区间，10.6 - 12.1）。其中，药品成本占比更高（31%），其次是食品（25%）。每位患者每月的平均间接成本为10.89美元（95%置信区间，10.4 - 11.4）。在本研究中，患者的初等教育程度、家庭规模（4 - 6人和>6人）、距医院距离（≥10公里）、是否有陪伴者以及高血压分期（二期）被确定为高血压疾病成本的预测因素。
与家庭月收入相比，高血压疾病成本非常高，使患者面临灾难性成本。因此，政府应给予应有关注，保护患者免受灾难性医疗支出的影响。
