即使在布基纳法索实行免费医疗的情况下，5岁以下儿童的医疗自付费用是否仍然存在？基于人群的横断面调查证据。

Do Out-of-Pocket Payments for Care for Children under 5 Persist Even in a Context of Free Healthcare in Burkina Faso? Evidence from a Cross-Sectional Population-Based Survey.

作者信息

Tapsoba Ludovic D G, Yara Mimbouré, Nakovics Meike I, Somda Serge M A, Lohmann Julia, Robyn Paul J, Hamadou Saidou, Hien Hervé, De Allegri Manuela

机构信息

Centre MURAZ, National Institute of Public Health, Bobo-Dioulasso 390, Burkina Faso.

Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, 69120 Heidelberg, Germany.

出版信息

Healthcare (Basel). 2023 May 10;11(10):1379. doi: 10.3390/healthcare11101379.

DOI:10.3390/healthcare11101379

PMID:37239664

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10218663/

Abstract

BACKGROUND

In April 2016, Burkina Faso began free healthcare for children aged from 0 to 5 years. However, its implementation faces challenges, and the goal of this study is to estimate the fees paid for this child care and to determine the causes of these direct payments.

METHODS

Data gathering involved 807 children aged from 0 to 5 years who had contact with the public healthcare system. The estimation of the determinants of out-of-pocket health payments involved the application of a two-part regression model.

RESULTS

About 31% of the children made out-of-pocket payments for healthcare (an average of 3407.77 CFA francs per case of illness). Of these, 96% paid for medicines and 24% paid for consultations. The first model showed that out-of-pocket payments were positively associated with hospitalization, urban area of residence, and severity of illness, were made in the East-Central and North-Central regions, and were negatively associated with the 7 to 23 month age range. The second model showed that hospitalization and severity of illness increased the amount of direct health payments.

CONCLUSION

Children targeted by free healthcare still make out-of-pocket payments. The dysfunction of this policy needs to be studied to ensure adequate financial protection for children in Burkina Faso.

摘要

背景

2016年4月，布基纳法索开始为0至5岁儿童提供免费医疗服务。然而，其实施面临挑战，本研究的目的是估算这种儿童护理所支付的费用，并确定这些直接支付的原因。

方法

数据收集涉及807名0至5岁与公共医疗系统有接触的儿童。自付医疗费用决定因素的估算涉及应用两部分回归模型。

结果

约31%的儿童为医疗保健自掏腰包（每例疾病平均3407.77非洲法郎）。其中，96%支付了药品费用，24%支付了诊疗费用。第一个模型显示，自付费用与住院、城市居住地区和疾病严重程度呈正相关，在中东部和中北部地区支付，与7至23个月的年龄范围呈负相关。第二个模型显示，住院和疾病严重程度增加了直接医疗支付的金额。