估算印度肺结核患者潜在的社会支持需求。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Susmita Chatterjee, Guy Stallworthy, Palash Das, Anna Vassall
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引用次数: 0

摘要

为肺结核(TB)患者提供社会支持是一项值得推荐的策略,因为肺结核患者所在的家庭会因治疗肺结核的高昂费用、巨大的收入损失和其他一些经济后果而陷入贫困的漩涡。然而,在全球范围内,社会支持的例子并不多。印度政府于 2018 年推出了 "Nikshay Poshan Yojana "计划,为所有登记在册的肺结核患者提供营养支持。每月 500 印度卢比(6 美元)的财政奖励被提议直接转入登记受益人的有效银行账户。在 2019 年至 2023 年期间,我们采用世界卫生组织推荐的全国结核病家庭成本估算方法,对四个邦 16 个地区的 1482 名成年药敏结核病患者进行了访谈,考察了福利的覆盖范围、时间、受益金额,以及福利在多大程度上减轻了灾难性成本(灾难性成本是指可能对家庭经济造成永久性负面影响的成本水平,因此可用作衡量对永久性经济福利影响的替代指标)。我们还估算了实现零灾难性费用目标所需的潜在社会支持金额。在治疗结束时,31%-54% 的研究参与者获得了补助。使用不同的估算方法,34%-60% 的肺结核患者需要支付灾难性费用,而补助金帮助 2% 的研究参与者保持在灾难性费用阈值以下。6 个月治疗的统一补助金额为 10000 印度卢比(127 美元),可将灾难性费用的发生率降低 43%。为了提高结核病患者的经济福利,需要大幅提高补助水平,这将对结核病计划的预算产生相当大的影响。因此,可以考虑采取有针对性而非普遍性的方法。为使影响最大化,至少应在治疗登记后立即发放修订后金额的一半。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estimation of potential social support requirement for tuberculosis patients in India.

Providing social support to tuberculosis (TB) patients is a recommended strategy as households having TB patients find themselves in a spiral of poverty because of high cost, huge income loss and several other economic consequences associated with TB treatment. However, there are few examples of social support globally. The Indian government introduced the 'Nikshay Poshan Yojana' scheme in 2018 to provide nutritional support for all registered TB patients. A financial incentive of 500 Indian Rupee (6 United States Dollars) per month was proposed to be transferred directly to the registered beneficiaries' validated bank accounts. We examined the reach, timing, amount of benefit receipt and the extent to which the benefit alleviated catastrophic costs (used as a proxy to measure the impact on permanent economic welfare as catastrophic cost is the level of cost that is likely to result in a permanent negative economic impact on households) by interviewing 1482 adult drug-susceptible TB patients from 16 districts of four states during 2019 to 2023, using the methods recommended by the World Health Organization for estimating household costs of TB nationally. We also estimated the potential amount of social support required to achieve a zero catastrophic cost target. At the end of treatment, 31-54% of study participants received the benefit. In all, 34-60% of TB patients experienced catastrophic costs using different estimation methods and the benefit helped 2% of study participants to remain below the catastrophic cost threshold. A uniform benefit amount of Indian Rupee 10 000 (127 United States Dollars) for 6 months of treatment could reduce the incidence of catastrophic costs by 43%. To improve the economic welfare of TB patients, levels of benefit need to be substantially increased, which will have considerable budgetary impact on the TB programme. Hence, a targeted rather than universal approach may be considered. To maximize impact, at least half of the revised amount should be given immediately after treatment registration.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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