Prasad Banuru Muralidhara, Tripathy Jaya Prasad, Bera Om Prakash, Shanbhag Namita
Tuberculosis and Communicable Diseases, International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India.
Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
J Family Med Prim Care. 2021 Aug;10(8):2853-2858. doi: 10.4103/jfmpc.jfmpc_2322_20. Epub 2021 Aug 27.
Globally people pay out-of-pocket (OOP) to access Oral healthcare services. In India, there is limited evidence on estimates of OOP expenditure. We undertook an analysis of national sample survey data on household health care expenditure to understand the expenditure pattern for Oral healthcare services and the catastrophic burden.
The expenditure reported for Oral healthcare services from two surveys: 71 round and 75 round, published by National Sample Survey Office (NSSO) was extracted. Based on monthly household consumption expenditure three economic groups were made: poor, middle- and rich-income groups. The OOP expenditure pattern while accessing day-care services and hospitalization and in public and private sector and the catastrophic expenditure were analysed.
A total of 204 and 155 households from two national surveys reported to have accessed day-care Oral services respectively. The median OOP expenditure in public sector remained same at US $ 4 in both surveys. Over 35% of 78 households in 71 round and 42% of 167 in 75 round used public sector hospitalization services. The median expenditure of hospitalization doubled from US$ 58 (IQR 21-263) in 71 round to US $ 125 (IQR 45-363) in 75 round. Households from poor income groups spent seven times more for Oral healthcare services during the recent survey and faced catastrophic expenditure.
The OOP expenditure for Oral healthcare has significant catastrophic household expenditure among the poor. There is a need to increase investment in public sector and insurance to protect poor against hospitalization expenditure in private sector.
在全球范围内,人们需要自掏腰包来获取口腔医疗服务。在印度,关于自付费用支出估计的证据有限。我们对全国住户医疗保健支出抽样调查数据进行了分析,以了解口腔医疗服务的支出模式和灾难性负担。
提取了国家抽样调查办公室(NSSO)公布的第71轮和第75轮两次调查中报告的口腔医疗服务支出。根据家庭每月消费支出划分了三个经济群体:贫困、中等收入和高收入群体。分析了获取日间护理服务和住院服务时在公共部门和私营部门的自付费用支出模式以及灾难性支出。
两次全国性调查分别有204户和155户家庭报告使用了日间护理口腔服务。在两次调查中,公共部门的自付费用中位数均为4美元。在第71轮调查的78户家庭中,超过35%以及在第75轮调查的167户家庭中,42%使用了公共部门的住院服务。住院费用中位数从第71轮的58美元(四分位距21 - 263美元)翻倍至第75轮的125美元(四分位距45 - 363美元)。在最近的调查中,贫困收入群体家庭在口腔医疗服务上的支出高出七倍,且面临灾难性支出。
口腔医疗的自付费用在贫困人群中造成了显著的灾难性家庭支出。有必要增加对公共部门和保险的投资,以保护贫困人口免受私营部门住院费用的影响。