Kumaravel K S, Anurekha V, Palanivelraja T, Gobinathan S, Gowri M, Ramya S
Department of Pediatrics, Govt. Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India.
Department of Community Medicine, Govt. Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India.
Indian J Community Med. 2023 Jul-Aug;48(4):615-618. doi: 10.4103/ijcm.ijcm_702_22. Epub 2023 Jul 14.
For effective policy making, it is important to understand out of pocket costs incurred in neonatal admissions in public hospitals. This cross sectional study was conducted with an objective to estimate out of pocket expenses expended on neonates and attenders during neonatal hospitalizations in a tertiary care referral hospital.
The data were collected using a pretested and semi structured questionnaire in 298 neonates during July'2022. Expenditures were reported as median values with interquartile range (IQR) and compared using the Kruskal Wallis test.
On analyzing the results, there were no direct medical costs. The median cost spent on food per day, transport during the stay, non medical expenses per day, and total expenses per day were Rs. 300 (IQR 200, 500), Rs. 1000 (500, 1500), Rs. 500 (333, 896), and Rs. 1080 (800, 1533), respectively. Higher expenses were associated with preterm, low birth weight, neonatal seizures, and longer stay (P values <0.001, 0.028, <0.001, and <0.001, respectively). About 9.39% and 1% of the families were found to be catastrophic health expenditures at 10% and 25% threshold levels, respectively.
To conclude, all the direct medical costs were borne by the caregiver. However, some non medical and indirect costs are associated with neonatal hospitalizations in public hospitals and cash benefit schemes can offset them.
为了制定有效的政策,了解公立医院新生儿住院的自付费用很重要。本横断面研究旨在估计一家三级医疗转诊医院新生儿住院期间新生儿及其陪护人员的自付费用。
2022年7月,使用预先测试的半结构化问卷收集了298名新生儿的数据。支出报告为中位数,并带有四分位间距(IQR),并使用Kruskal Wallis检验进行比较。
分析结果发现,没有直接医疗费用。每天的食品费用、住院期间的交通费用、每天的非医疗费用以及每天的总费用中位数分别为300卢比(IQR 200,500)、1000卢比(500,1500)、500卢比(333,896)和1080卢比(800,1533)。较高的费用与早产、低出生体重、新生儿惊厥和住院时间较长有关(P值分别<0.001、0.028、<0.001和<0.001)。分别有9.39%和1%的家庭在10%和25%的阈值水平上出现灾难性医疗支出。
总之,所有直接医疗费用均由照顾者承担。然而,公立医院的新生儿住院会产生一些非医疗和间接费用,现金福利计划可以抵消这些费用。