Pathak Vineet Kumar, Haldar Partha, Kant Shashi, Krishnan Anand, Gupta Sanjeev K
Community Medicine, Shree Guru Gobind Singh Tricentenary University (SGT University), Gurugram, IND.
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Cureus. 2023 Apr 15;15(4):e37626. doi: 10.7759/cureus.37626. eCollection 2023 Apr.
A significant portion of India's 1.2 billion population consists of elderly individuals, accounting for approximately 8.6%, who incur substantial out-of-pocket (OOP) healthcare expenses. Any policy for the elderly should encompass financial protection from illness-related expenditures. However, the lack of comprehensive information on OOP expenditure and its determinants precludes such action.
We conducted a cross-sectional study of 400 elderly persons residing in the rural town of Ballabgarh. The participants were randomly selected using the health demographic surveillance system. We utilized questionnaires and tools to assess the costs associated with outpatient and inpatient services in the previous year, as well as gather information on socio-demographics (individual characteristics), morbidity (motivation for seeking care), and social engagement (health-seeking).
A total of 396 elderly persons participated, with a mean (SD) age of 69.4 (6.7), and 59.4% females. Nearly 96% and 50% of the elderly availed of outpatient and inpatient services, respectively, in the preceding year. The mean (IQR) annual OOP expenditure, as per the consumer price index 2021, was INR 12,543 (IQR, INR 8,288-16,787), with a median of INR 2,860 (IQR, INR 1,458-7,233), explained significantly by sex, morbidity status, social engagement, and mental health.
In low-middle-income countries like India, policymakers may consider pre-payment mechanisms like health insurance for the elderly, using such prediction scores.
印度12亿人口中有很大一部分是老年人，约占8.6%，他们承担着大量的自付医疗费用。任何针对老年人的政策都应包括防范与疾病相关支出的财务保护。然而，缺乏关于自付费用及其决定因素的全面信息阻碍了此类行动。
我们对居住在巴拉加尔农村镇的400名老年人进行了一项横断面研究。参与者是使用健康人口监测系统随机选取的。我们使用问卷和工具来评估上一年门诊和住院服务的相关费用，并收集社会人口统计学（个人特征）、发病率（就医动机）和社会参与（寻求医疗保健）方面的信息。
共有396名老年人参与，平均（标准差）年龄为69.4（6.7）岁，女性占59.4%。上一年，分别有近96%和50%的老年人使用了门诊和住院服务。根据2021年消费价格指数，年自付费用的平均（四分位距）为12,543印度卢比（四分位距，8,288 - 16,787印度卢比），中位数为2,860印度卢比（四分位距，1,458 - 7,233印度卢比），性别、发病状况、社会参与和心理健康对其有显著影响。
在印度这样的低中收入国家，政策制定者可以考虑使用此类预测分数，为老年人采用医疗保险等预付机制。
