印度德里市公立医疗机构中对抗疗法和阿育吠陀门诊护理的单位成本。
Unit costs for allopathic and AYUSH outpatient care in public facilities in Urban Delhi, India.
作者信息
Garg Charu C, Goyanka Roopali
机构信息
Health and Nutrition-Research Programme, Institute for Human Development, New Delhi, India.
Syzygy Consulting, LLC, CA, USA.
出版信息
J Family Med Prim Care. 2023 Nov;12(11):2752-2756. doi: 10.4103/jfmpc.jfmpc_2289_22. Epub 2023 Nov 21.
INTRODUCTION
The National Health Policy, 2017, suggests pluralism in health care with the integrated delivery of AYUSH and allopathic care at public facilities. Information on unit cost of outpatient visits for both types of care at public facilities is useful to guide the policies on health-care delivery.
METHODS
The costs in 2019-20 were estimated for each type of care at allopathic urban primary health center (UPHC) and AYUSH facilities using top-down methodology and adding out-of-pocket expenditures (OOPE) incurred to reflect true costs. Data from national health survey, annual government budgets, and reports were used.
RESULTS
The average cost of an outpatient visit for allopathic care was ₹325 at a UPHC and ₹189 in a homeopathic dispensary and ₹692 in an Ayurvedic dispensary. While OOPE per visit at UPHC was ₹177, no OOPE was incurred at AYUSH facilities. The government expenditure per visit for allopathic care at UPHC at ₹148 was the lowest compared to any type of AYUSH care. The cost per facility for allopathic UPHC was higher than both Ayurvedic and homeopathic dispensaries. Unani dispensaries were least cost-effective, both in terms of cost per visit and cost per facility.
CONCLUSION
Costs per visit at a facility are impacted by footfalls. For Ayurveda, despite lower facility costs as compared to UPHC, per visit costs were higher due to low utilization. Improving evidence-based utilization of AYUSH care is critical for the success of the government policy of mainstreaming AYUSH care at low cost.
引言
《2017年国家卫生政策》建议在医疗保健领域实现多元化,在公共设施中综合提供阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法和对抗疗法护理。了解公共设施中这两种护理的门诊单位成本信息有助于指导医疗保健服务提供政策。
方法
采用自上而下的方法,估算了2019 - 20年城市对抗疗法初级卫生中心(UPHC)和阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法设施中每种护理类型的成本,并加上自付费用(OOPE)以反映真实成本。使用了来自国家卫生调查、年度政府预算和报告的数据。
结果
在城市对抗疗法初级卫生中心,一次门诊的平均成本为325卢比,在顺势疗法药房为189卢比,在阿育吠陀药房为692卢比。虽然城市对抗疗法初级卫生中心每次就诊的自付费用为177卢比,但阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法设施无需自付费用。城市对抗疗法初级卫生中心每次就诊的政府支出为148卢比,与任何类型阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法护理相比是最低的。城市对抗疗法初级卫生中心每个机构的成本高于阿育吠陀药房和顺势疗法药房。尤那尼药房在每次就诊成本和每个机构成本方面都是最不具成本效益的。
结论
机构的每次就诊成本受就诊人数影响。对于阿育吠陀医学,尽管与城市对抗疗法初级卫生中心相比机构成本较低,但由于利用率低,每次就诊成本较高。提高阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法护理的循证利用率对于政府以低成本将阿育吠陀医学、尤那尼医学、悉达医学、顺势疗法护理纳入主流的政策取得成功至关重要。