Manghat Sreeja, Kar Sitanshu, Bethou Adhisivam, Sarkar Sonali
Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.
Cureus. 2023 Jul 7;15(7):e41507. doi: 10.7759/cureus.41507. eCollection 2023 Jul.
Background Common childhood illnesses such as diarrhea, fever, and acute respiratory infection impose substantial health burdens among under-five children, and Low Birth Weight (LBW) has been associated with an increased prevalence of these illnesses. However, the impact of LBW on healthcare utilization and the economic burden of these illnesses remains understudied. Aim To assess the impact of LBW on the prevalence, healthcare utilization, and Out of Pocket Expenditure (OOPE) for outpatient (OP) treatment of selected Common Childhood Illnesses (CCHI) among under-five children in India. Methodology This study utilized data from two nationally representative surveys conducted in India; National Family Health Survey (NFHS-5) (2019-2021) and the National Sample Survey Organization (NSSO) 75th Round Schedule Social Consumption: Health (2017-2018). Data from the NFHS-5 was analyzed to assess the impact of LBW on the prevalence of selected CCHI and healthcare utilization. Comparison of OOPE for OP treatment of selected CCHI between LBW and Normal Birth Weight (NBW) children done using the median OOPE for OP visits of CCHI estimated from the NSSO data. Results The two-week prevalence of selected CCHI among LBW and NBW children was found to be 20.0% (95% CI 19.6 -20.4) and 18.0% (95% CI 17.8 -18.2), respectively. There was no significant difference between LBW and NBW children on healthcare utilization for the treatment of CCHI; both groups had a similar proportion (around 70%) of formal medical treatment utilization for CCHI. The median OOPE spending for OP visits per episode of CCHI was comparable between LBW and NBW children. However, families of LBW children had higher annual OOPE spending for OP visits related to CCHI, with projected estimates of INR 1,446 ($19.56) for LBW children and INR 1,271 ($17.2) for NBW children. Conclusion LBW was associated with a higher prevalence of CCHI. Even though healthcare utilization was similar among LBW and NBW children, a higher prevalence of CCHI among LBW children led to higher OOPE. LBW children have approximately 13% higher annual OOPE spending for the OP visits related to selected CCHI compared to NBW children.
腹泻、发烧和急性呼吸道感染等常见儿童疾病给五岁以下儿童带来了沉重的健康负担，低出生体重（LBW）与这些疾病的患病率增加有关。然而，低出生体重对医疗保健利用和这些疾病的经济负担的影响仍未得到充分研究。目的：评估低出生体重对印度五岁以下儿童门诊（OP）治疗选定常见儿童疾病（CCHI）的患病率、医疗保健利用和自付费用（OOPE）的影响。方法：本研究利用了印度进行的两项具有全国代表性的调查数据；全国家庭健康调查（NFHS-5）（2019-2021年）和国家抽样调查组织（NSSO）第75轮社会消费：健康调查（2017-2018年）。分析NFHS-5的数据，以评估低出生体重对选定CCHI患病率和医疗保健利用的影响。使用从NSSO数据估计的CCHI门诊就诊的自付费用中位数，比较低出生体重儿童和正常出生体重（NBW）儿童在选定CCHI门诊治疗的自付费用。结果：低出生体重儿童和正常出生体重儿童中选定CCHI的两周患病率分别为20.0%（95%CI 19.6-20.4）和18.0%（95%CI 17.8-18.2）。低出生体重儿童和正常出生体重儿童在CCHI治疗的医疗保健利用方面没有显著差异；两组接受CCHI正规医疗治疗的比例相似（约70%）。低出生体重儿童和正常出生体重儿童每例CCHI门诊就诊的自付费用中位数相当。然而，低出生体重儿童家庭因CCHI门诊就诊的年度自付费用较高，预计低出生体重儿童为1446印度卢比（19.56美元），正常出生体重儿童为1271印度卢比（17.2美元）。结论：低出生体重与CCHI的较高患病率相关。尽管低出生体重儿童和正常出生体重儿童的医疗保健利用相似，但低出生体重儿童中较高的CCHI患病率导致了更高的自付费用。与正常出生体重儿童相比，低出生体重儿童因选定CCHI门诊就诊的年度自付费用高出约13%。
