Sauerborn R, Ibrango I, Nougtara A, Borchert M, Hien M, Benzler J, Koob E, Diesfeld H J
Harvard Institute for International Development, Cambridge, USA.
Trop Med Parasitol. 1995 Mar;46(1):54-60.
Analyses of the health costs in developing countries have mainly dealt with provider costs. This is in spite of the fact that the bulk of illness related costs is borne by households. Where studied, household time and financial costs have not been treated in a comprehensive way. However, an incomplete cost assessment will lead to an underestimation of household costs. Using data from a household interview survey in a rural area of Burkina Faso, the authors carried out an exhaustive assessment of the economic cost of illness that households incur. Financial costs included out-of-pocket expenditures for drugs, fees, transport to the treatment site, lodging and food for accompanying household members. Time costs, in turn, were comprised of production foregone both by the sick person and by healthy household members, who tended to the sick. Time costs amounted to by far the largest proportion (73%) of total household costs. Of the total amount of illness related time loss of the average household, 45% was due to the fact that healthy household members tended to or accompanied their sick kin. Of the financial cost items, expenditures for drugs or traditional products represented 62%. When Western type services were sought, expenditures for transport, food etc., exceeded those for treatment fees. Total cost of illness was 4,002 F CFA/month for the average household. This amounted to 3.7% of household income and to 6.2% of household expenditures in the reference month. The authors discuss policy measures aimed to reduce household time costs.(ABSTRACT TRUNCATED AT 250 WORDS)
对发展中国家医疗成本的分析主要关注的是医疗机构的成本。尽管事实上与疾病相关的大部分费用是由家庭承担的。在已开展研究的地方,家庭的时间和经济成本并未得到全面考量。然而,不完整的成本评估会导致对家庭成本的低估。作者利用布基纳法索农村地区家庭访谈调查的数据,对家庭所承担的疾病经济成本进行了详尽评估。经济成本包括购买药品的自付费用、诊疗费、前往治疗地点的交通费、住宿费以及陪同家庭成员的食品费用。时间成本则包括病人以及照顾病人的健康家庭成员所损失的生产时间。时间成本在家庭总成本中所占比例最大,达73%。在平均家庭与疾病相关的总时间损失中,45%是由于健康家庭成员照顾或陪伴生病的亲属所致。在各项经济成本中,药品或传统产品的支出占62%。当寻求西式医疗服务时,交通、食品等方面的支出超过了诊疗费。平均每个家庭每月的疾病总成本为4002非洲法郎。这相当于参考月份家庭收入的3.7%和家庭支出的6.2%。作者讨论了旨在降低家庭时间成本的政策措施。(摘要截选至250词)