埃塞俄比亚的糖尿病患者是否免受经济困难的影响？
Are Ethiopian diabetic patients protected from financial hardship?
机构信息
Department of Health Systems Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
PLoS One. 2021 Jan 27;16(1):e0245839. doi: 10.1371/journal.pone.0245839. eCollection 2021.
BACKGROUND
Globally, diabetes mellitus exerts an economic burden on patients and their families. However, the economic burden of diabetes mellitus and its associated factors were not well studied in Ethiopia. Therefore, the aim of this study is to assess the economic burden of diabetes mellitus and its associated factors among diabetic patients in public hospitals of Bahir Dar city administration, Ethiopia.
METHODS
Across sectional study was conducted on 422 diabetic patients. The patients were selected by simple random sampling method. The prevalence-based model was used to estimate the costs on patients' perspective. Bottom up and human capital approaches were used to estimate the direct and indirect costs of the patients respectively. Wealth index was constructed using principal component analysis by SPSS. Forty percent of nonfood threshold level was used to measure catastrophic diabetic care expenditure of diabetic patients. Whereas, the World Bank poverty line (the $1.90-a-day poverty line) was used to measure impoverishment of patients due to expenses of diabetes mellitus care. Data were entered by Epi data version 3.1and exported to SPSS version 23 for analysis. Simple and multiple logistic regressions were used.
RESULTS
Four hundred one respondents were interviewed with response rate of 95%. We found that 239 (59.6%) diabetic patients incurred catastrophic diabetic care expenditure at 40% nonfood threshold level. Whereas, 20 (5%) diabetic patients were impoverished by diabetic care spending at the $1.90-a-day poverty line. Educational status of respondent, educational status of the head of household, occupation and wealth status were statistically associated with the catastrophic diabetic care expenditure.
CONCLUSIONS
The study revealed that the economic burden of diabetic care is very disastrous among the less privileged populations: the less educated, the poorest and unemployed. Therefore, all concerned stakeholders should design ways that can reduce the financial hardship of diabetic care among diabetic patients.
背景
全球范围内，糖尿病给患者及其家庭带来了经济负担。然而，在埃塞俄比亚，糖尿病的经济负担及其相关因素尚未得到充分研究。因此，本研究旨在评估巴塞尔达市行政公立医院糖尿病患者的糖尿病经济负担及其相关因素。
方法
本研究采用横断面研究，对 422 名糖尿病患者进行了研究。采用简单随机抽样方法选择患者。采用基于患病率的模型从患者角度估算费用。采用自下而上和人力资本方法分别估算患者的直接和间接费用。使用 SPSS 的主成分分析构建财富指数。采用 40%的非食品阈值来衡量糖尿病患者灾难性的糖尿病护理支出。而世界银行贫困线（每天 1.90 美元的贫困线）则用于衡量因糖尿病护理费用而导致的患者贫困程度。数据通过 EpiData 版本 3.1 输入，然后导出到 SPSS 版本 23 进行分析。采用简单和多元逻辑回归进行分析。
结果
对 401 名受访者进行了访谈，应答率为 95%。我们发现，在 40%的非食品阈值水平下，有 239 名（59.6%）糖尿病患者发生了灾难性的糖尿病护理支出。而在每天 1.90 美元的贫困线水平下，有 20 名（5%）糖尿病患者因糖尿病护理费用而陷入贫困。受访者的教育程度、家庭主要成员的教育程度、职业和财富状况与灾难性糖尿病护理支出有统计学关联。
结论
研究表明，在教育程度较低、最贫困和失业的弱势群体中，糖尿病护理的经济负担非常严重。因此，所有相关利益攸关方都应设计能够减轻糖尿病患者糖尿病护理经济负担的方法。
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