慢性病的自付负担：比利时、捷克和德国老年人的案例
The out-of-pocket burden of chronic diseases: the cases of Belgian, Czech and German older adults.
作者信息
Kočiš Krůtilová Veronika, Bahnsen Lewe, De Graeve Diana
机构信息
Faculty of Business and Economics, Mendel University in Brno, Zemedelska 1, 613 00, Brno, Czech Republic.
Institute for Public Finance and Social Policy, Albert-Ludwigs-University of Freiburg, P.O. Box, 79085, Freiburg, Germany.
出版信息
BMC Health Serv Res. 2021 Mar 17;21(1):239. doi: 10.1186/s12913-021-06259-w.
BACKGROUND
Out-of-pocket payments have a diverse impact on the burden of those with a higher morbidity or the chronically ill. As the prevalence of chronic diseases increases with age, older adults are a vulnerable group. The paper aims to evaluate the impact of chronic diseases on the out-of-pocket payments burden of the 50+ populations in Belgium, the Czech Republic and Germany.
METHODS
Data from the sixth wave of the Survey of Health, Ageing and Retirement in Europe is used. A two-part model with a logit model in the first part and a generalised linear model in the second part is applied.
RESULTS
The diseases increasing the burden in the observed countries are heart attacks, high blood pressure, cancer, emotional disorders, rheumatoid arthritis and osteoarthritis. Reflecting country differences Parkinson's disease and its drug burden is relevant in Belgium, the drugs burden related to heart attack and outpatient care burden to chronic kidney disease in the Czech Republic and the outpatient care burden of cancer and chronic lung disease in Germany. In addition, we confirm the regressive character of out-of-pocket payments.
CONCLUSIONS
We conclude that the burden is not equitably distributed among older adults with chronic diseases. Identification of chronic diseases with a high burden can serve as a supplementary protective feature.
背景
自付费用对发病率较高者或慢性病患者的负担有不同影响。随着慢性病患病率随年龄增长而上升，老年人是弱势群体。本文旨在评估慢性病对比利时、捷克共和国和德国50岁及以上人群自付费用负担的影响。
方法
使用欧洲健康、老龄化和退休调查第六波的数据。应用一个两部分模型，第一部分为逻辑回归模型，第二部分为广义线性模型。
结果
在所观察的国家中，增加负担的疾病有心脏病发作、高血压、癌症、情绪障碍、类风湿性关节炎和骨关节炎。反映国家差异的是，帕金森病及其药物负担在比利时较为突出，捷克共和国与心脏病发作相关的药物负担以及与慢性肾病相关的门诊护理负担，德国则是癌症和慢性肺病的门诊护理负担。此外，我们证实了自付费用的累退性。
结论
我们得出结论，负担在患有慢性病的老年人中分配不均。识别负担较重的慢性病可作为一种补充性保护措施。
Zotero 插件