Disease-specific distress healthcare financing and catastrophic out-of-pocket expenditure for hospitalization care in Bangladesh.

IF 2.5 4区 医学 Q3 HEALTH POLICY & SERVICES
Abdur Razzaque Sarker, Anik Hasan, Rasedul Islam
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Abstract

Background: Out-of-pocket (OOP) expenditure is one of the most common payment strategies for hospitalization care in Bangladesh, and the share of OOP expenditure has been increasing at an alarming rate. This study aimed to investigate the OOP costs of hospitalization care, the impact of OOP on catastrophic healthcare expenditure (CHE) and financial distress, and the associated factors.

Methods: We used data from the most recent nationally representative dataset, the Bangladesh Household Income and Expenditure Survey 2022. A total of 14,395 households were surveyed, with 1973 household members hospitalized due to various illnesses. Respondents were asked to provide information regarding hospitalization care for the year preceding the survey. Households were considered to have CHE if they spent at least 25% of their total consumption expenditure or 40% of their non-food consumption expenditure on healthcare. Distress financing was defined as covering OOP healthcare costs by selling assets, borrowing money, or receiving financial assistance from friends or relatives. Multivariate logistic regression models were used to identify the determinants of CHE and distress financing.

Results: The annual average OOP cost of hospitalization was USD 418, with the OOP cost nearly twice as high in private facilities compared to public ones (USD 538 vs. USD 283). The highest OOP costs were observed for cancer treatment (USD 2365), followed by COVID-19 (USD 1391). Overall, 6.72% and 9.03% of hospitalized patients experienced CHE at 25% of total expenditure and 40% of non-food expenditure, respectively, while about 61% of patients faced distress financing due to hospitalization.

Conclusion: Financial hardship due to hospitalization remains high in Bangladesh. These findings will help policymakers adopt more effective healthcare financing strategies and improve the efficiency of public health investments.

孟加拉国特定疾病的窘迫医疗保健融资和住院护理的灾难性自付费用。
背景:自付费用是孟加拉国住院治疗最常见的支付策略之一,自付费用所占比例一直在以惊人的速度增长。本研究旨在探讨住院护理的面向对象成本、面向对象对灾难性医疗支出(CHE)和财务困境的影响及其相关因素。方法:我们使用的数据来自最新的全国代表性数据集——《2022年孟加拉国家庭收入和支出调查》。总共调查了14 395户家庭,其中有1973名家庭成员因各种疾病住院。受访者被要求提供调查前一年的住院治疗情况。如果家庭将至少25%的总消费支出或40%的非食品消费支出用于医疗保健,则被视为拥有医疗保健。困境融资被定义为通过出售资产、借款或接受朋友或亲戚的经济援助来支付OOP的医疗费用。多变量logistic回归模型用于确定CHE和困境融资的决定因素。结果:每年平均住院费用为418美元,私立医院的住院费用几乎是公立医院的两倍(538美元对283美元)。癌症治疗的OOP费用最高(2365美元),其次是COVID-19(1391美元)。总体而言,6.72%和9.03%的住院患者分别在总支出的25%和非食品支出的40%中经历了CHE,而约61%的患者因住院而面临窘迫融资。结论:住院造成的经济困难在孟加拉国仍然很高。这些发现将有助于决策者采取更有效的医疗融资战略,提高公共卫生投资的效率。
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来源期刊
Cost Effectiveness and Resource Allocation
Cost Effectiveness and Resource Allocation HEALTH POLICY & SERVICES-
CiteScore
3.40
自引率
4.30%
发文量
59
审稿时长
34 weeks
期刊介绍: Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.
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