尼泊尔家庭医疗保健支付的决定因素:来自生活水平调查III数据的证据

A. Thapa, S. Singla
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摘要

保健筹资始终是尼泊尔政府确保人人平等和可获得基本保健服务的一个重要发展问题,但保健筹资的最大部分是由家庭的私人筹资来源——自掏腰包支付的。因此,本研究旨在评估民营医疗融资的现状,并分析影响民营医疗融资的因素。基于尼泊尔CBS(2012)的生活水平调查数据,设计了横断面描述性和分析性研究。这是一个包含5988户家庭的丰富且具有全国代表性的数据。本研究运用逻辑回归分析自费支付的决定因素。该研究的主要发现表明,某一特定家庭的平均医疗成本为NRs。急性病和医药费占费用的主要部分。城镇居民、山区居民、第三省家庭和最高财富五分之一人群的平均OOP医疗费用较高。男性户主家庭、较大家庭和属于第2省的家庭面临OOP支付的几率增加。相反,居住在城市和第4省的家庭面临OOP的几率降低。研究认为,自费支付是民营医疗融资的重要来源。因此,有必要有效实施需求方融资计划和医疗保险计划,以保护家庭免受经济负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Determinants of Household’s Healthcare Payment in Nepal: Evidence from Living Standard Survey III Data
Healthcare financing has always remained an important development issue for Government of Nepal to ensure equity and availability of basic health care services for all but the largest portion of health financing is met by out of pocket payment (OOP), a private financing source of households. So this study aims to assess the situation of private healthcare financing and analyze the factors associated with it. A cross sectional descriptive cum analytical study was designed based on living standard survey data of CBS (2012), Nepal. It is a rich and country wide representative data comprising 5988 households. The study applied logistic regression to analyze the determinants of out of pocket payment. The major findings of the study shows a particular household’s mean healthcare cost was NRs. 1119 for acute illness and cost of medicine occupied the major portion of the cost. The mean OOP healthcare cost is higher for urban residents, mountain dwellers, and households belonging to province 3 and people belonging to highest wealth quintiles. The odds of household facing OOP payment increases for male headed households, larger households and households belonging to province number 2. Conversely, odds of household facing OOP decreases for households residing in urban and province number4.  The study concludes that out of pocket payment is an important source of private healthcare financing source. So there is a need to effectively implement the demand side financing programs and health insurance scheme to protect households from financial burden. 
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