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埃塞俄比亚东北部德西综合专科医院定期随访的糖尿病患者的医疗服务负担能力及其影响因素。

Affordability of health services and associated factors among patients with diabetes mellitus under regular follow-up at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia.

机构信息

Department of Health System Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

BMC Health Serv Res. 2024 Nov 21;24(1):1444. doi: 10.1186/s12913-024-11846-8.

Abstract

BACKGROUND

The burden of chronic illnesses, including cardiovascular disease and diabetes, is increasing in low- and middle-income countries. However, health systems often struggle to meet the needs of chronically ill patients. Affordability is crucial in ensuring access to quality healthcare for patients with diabetes mellitus (DM) and evaluating healthcare costs. Therefore, this study aimed to assess the affordability of health services and identify associated factors among DM patients receiving regular follow-ups at Dessie Comprehensive Specialized Hospital in Northeast Ethiopia, 2023.

METHODS

A cross-sectional study was conducted among 392 DM patients at Dessie Comprehensive Specialized Hospital (DCSH) from July 1 to 30, 2023. Data was collected using a structured questionnaire and chart review checklist. Systematic random sampling was employed, and the data were analyzed using EPI INFO version 7 and SPSS version 26. The outcome variable, affordability of health services, was measured by five items using a structured questionnaire. Logistic regression analysis was performed to identify significant factors associated at 95% confidence interval using odds ratio.

RESULTS

Most participants were married (74.2%), and 55.9% were male. Among the DM patients, 211 (53.83%) found the health services affordable, with an interval of 48.85-58.72% at a 95% confidence interval with a p-value less than 0.05. Factors significantly associated with healthcare affordability included marital status, family size, average monthly income, and brand prescription.

CONCLUSION

The study revealed that healthcare services were affordable for approximately half of the DM patients. However, this level of affordability falls short of the ideal standard. Improving the affordability and accessibility of healthcare services for DM patients, particularly those from low-income backgrounds, is crucial to ensuring better health outcomes.

摘要

背景

在中低收入国家,慢性病(包括心血管疾病和糖尿病)的负担正在增加。然而,卫生系统往往难以满足慢性病患者的需求。对于糖尿病(DM)患者来说,支付能力对于确保获得高质量的医疗保健至关重要,同时还需要评估医疗保健成本。因此,本研究旨在评估埃塞俄比亚东北部德西综合专科医院(Dessie Comprehensive Specialized Hospital)接受常规随访的 DM 患者的医疗服务支付能力,并确定相关因素,研究时间为 2023 年。

方法

2023 年 7 月 1 日至 30 日,在德西综合专科医院(Dessie Comprehensive Specialized Hospital)进行了一项横断面研究,共纳入 392 名 DM 患者。通过结构化问卷和图表审查清单收集数据。采用系统随机抽样,使用 EPI INFO 版本 7 和 SPSS 版本 26 进行数据分析。使用结构化问卷测量医疗服务支付能力的结果变量,通过五个项目进行衡量。使用比值比(odds ratio)在 95%置信区间内进行 logistic 回归分析,以确定有意义的关联因素。

结果

大多数参与者已婚(74.2%),55.9%为男性。在 DM 患者中,有 211 名(53.83%)认为医疗服务可负担得起,95%置信区间为 48.85-58.72%,p 值小于 0.05。与医疗保健可负担性显著相关的因素包括婚姻状况、家庭规模、月平均收入和品牌处方。

结论

研究表明,大约一半的 DM 患者能够负担得起医疗服务。然而,这种可负担性水平仍低于理想标准。提高 DM 患者,特别是低收入背景患者的医疗保健可负担性和可及性对于改善健康结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eaf/11580184/e30820ac7d65/12913_2024_11846_Fig1_HTML.jpg

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