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探索非传染性疾病导致的灾难性卫生支出及其应对策略:孟加拉国家庭的案例研究

Exploring the effects catastrophic health expenditure due to non-communicable diseases and coping strategies: A case study among households in Bangladesh.

作者信息

Awal Chowdhury N M Rabiul, Urme Salma Akter, Hridoy Asaduzzaman, Nusrat Fahima, Miah Md Shahgahan

机构信息

Department of Anthropology, Comilla University, Comilla, Bangladesh.

Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh.

出版信息

Public Health Pract (Oxf). 2025 Jul 10;10:100642. doi: 10.1016/j.puhip.2025.100642. eCollection 2025 Dec.

Abstract

OBJECTIVES

Non-communicable diseases (NCDs), due to their chronic nature, lead to long-term and significant health burdens that result in catastrophic expenses for individuals and communities. This study explores the socioeconomic effects of catastrophic health costs on households with family members experiencing NCDs and their coping mechanisms in rural areas of Bangladesh.

STUDY DESIGN

Qualitative study.

METHODS

Case studies were conducted with ten NCD patients who had experienced catastrophic events and their close contacts. Purposive sampling strategies were used to recruit participants from two sub-districts in areas with a high prevalence of NCDs. In-depth interviews and observations were conducted, and documents (e.g. hospital and diagnosis bills, medicine purchase receipts) were reviewed. Data were analysed using thematic analysis.

RESULTS

Data revealed that the treatment costs of NCDs are multifaceted and long-term. This catastrophic health expenditure has many economic effects, such as compromising food, housing, living standards and quality of life. It also has non-economic effects, including social stigmatisation, adjusting wishes and dreams, hampering children's education, disrupting family relationships and undermining social dignity. Households' adaptive strategies include loaning and borrowing, selling assets, using savings, seeking assistance from friends and relatives, reconciling living standards and even adopting alternative medicines.

CONCLUSIONS

Thisstudy highlights the socioeconomic impact of catastrophic health costs associated with NCDs and how households adapt and cope with these expenses. The results increase understanding of the impact of NCDs and the importance of managing the economic burden. Results highlight the necessity for a strategic plan to aid families affected by chronic NCDs.

摘要

目标

非传染性疾病因其慢性性质,会导致长期且严重的健康负担,给个人和社区带来灾难性费用。本研究探讨了灾难性医疗费用对孟加拉国农村地区有家庭成员患非传染性疾病的家庭的社会经济影响及其应对机制。

研究设计

定性研究。

方法

对十名经历过灾难性事件的非传染性疾病患者及其密切接触者进行了案例研究。采用目的抽样策略从非传染性疾病高流行地区的两个分区招募参与者。进行了深入访谈和观察,并审查了文件(如医院和诊断账单、药品购买收据)。使用主题分析法对数据进行了分析。

结果

数据显示,非传染性疾病的治疗费用是多方面且长期的。这种灾难性医疗支出有许多经济影响,如影响食物、住房、生活水平和生活质量。它也有非经济影响,包括社会污名化、调整愿望和梦想、妨碍子女教育、破坏家庭关系以及损害社会尊严。家庭的适应策略包括借贷、出售资产、动用储蓄、向朋友和亲戚求助、调整生活水平甚至采用替代药物。

结论

本研究强调了与非传染性疾病相关的灾难性医疗费用的社会经济影响以及家庭如何适应和应对这些费用。研究结果增进了对非传染性疾病影响以及管理经济负担重要性的理解。结果凸显了制定战略计划以帮助受慢性非传染性疾病影响家庭的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a4/12281525/d64226e64fe9/gr1.jpg

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