Health Technology Assessment Resource Centre, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Expert Rev Pharmacoecon Outcomes Res. 2022 Apr;22(3):455-463. doi: 10.1080/14737167.2021.1941883. Epub 2021 Jun 21.
To estimate the out-of-pocket (OOP) expenditure and catastrophic expenditure due to stroke-related hospitalization and determine associated predictors.
Secondary analysis of household-based survey conducted by National Sample Survey Organization from June 2017 to 2018.
A total of 1152 and 407 individuals reported stroke-related hospitalization and outpatient care, respectively, in the survey. Stroke-related hospitalization rate in India is 46 per 100,000 persons. The mean and median expenditure per episode of stroke-related hospitalization was INR 40,360 (US$ 539.75) and INR 17,140 (US$ 229.22), respectively, with significant OOP hospitalization expenditure across wealth quintiles ( < 0.001). About 29% (25-34%) of households seeking stroke treatment in public medical institutions experienced catastrophic expenditure. 37% (34-40%) of households resorted to distress health financing due to stroke-related hospitalization. Medicines accounted on an average 38% and 73% of public sector hospitalization and outpatient care, respectively. Patients treated in a private facility, hospitalized for over 7 days, within the poorest wealth quintiles had higher odds of incurring catastrophic expenditure.
Economic burden associated with stroke-related hospitalization is substantial in India. The publicly funded health insurance scheme should cover expenses on stroke-related medicines to reduce OOP expenditure of patients seeking treatment in public sector facilities.
估算因脑卒中住院产生的自付费用和灾难性支出，并确定相关预测因素。
对国家抽样调查组织于 2017 年 6 月至 2018 年进行的基于家庭的调查进行二次分析。
调查中分别有 1152 人和 407 人报告了脑卒中相关住院和门诊治疗。印度的脑卒中相关住院率为每 10 万人中有 46 人。脑卒中相关住院治疗的每次发作的平均和中位数支出分别为 40360 印度卢比（539.75 美元）和 17140 印度卢比（229.22 美元），不同财富五分位数之间的自付住院支出存在显著差异（<0.001）。约 29%（25-34%）在公立医疗机构寻求脑卒中治疗的家庭经历了灾难性支出。37%（34-40%）因脑卒中相关住院而诉诸于紧急健康融资。药品平均占公立医疗机构住院和门诊治疗费用的 38%和 73%。在最贫穷的五分位数中，在私立机构接受治疗、住院超过 7 天的患者，发生灾难性支出的可能性更高。
在印度，与脑卒中相关的住院治疗相关的经济负担相当大。公共资助的健康保险计划应涵盖与脑卒中相关的药品费用，以减少在公立医疗机构接受治疗的患者的自付费用。
