谁来支付治疗疟疾的费用?乌干达疟疾的疾病成本、公平性和经济负担分析。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Katherine Snyman, Catherine Pitt, Angelo Aturia, Joyce Aber, Samuel Gonahasa, Jane Frances Namuganga, Joaniter Nankabirwa, Emmanuel Arinaitwe, Catherine Maiteki-Sebuguzi, Henry Katamba, Jimmy Opigo, Fred Matovu, Grant Dorsey, Moses R Kamya, Walter Ochieng, Sarah G Staedke
{"title":"谁来支付治疗疟疾的费用?乌干达疟疾的疾病成本、公平性和经济负担分析。","authors":"Katherine Snyman, Catherine Pitt, Angelo Aturia, Joyce Aber, Samuel Gonahasa, Jane Frances Namuganga, Joaniter Nankabirwa, Emmanuel Arinaitwe, Catherine Maiteki-Sebuguzi, Henry Katamba, Jimmy Opigo, Fred Matovu, Grant Dorsey, Moses R Kamya, Walter Ochieng, Sarah G Staedke","doi":"10.1093/heapol/czae093","DOIUrl":null,"url":null,"abstract":"<p><p>Case management of malaria in Africa has evolved markedly over the past twenty years and updated cost estimates are needed to guide malaria control policies. We estimated the cost of malaria illness to households and the public health service and assessed the equity of these costs in Uganda. From December 2021 to May 2022, we conducted a costing exercise in eight government-run health centres covering seven sub-regions, collecting health service costs from patient observations, records review, and a time-and-motion study. From November 2021 to January 2022, we gathered data on households' cost of illness from randomly selected households for 614 residents with suspected malaria. Societal costs of illness were estimated and combined with secondary data sources to estimate the total economic burden of malaria in Uganda. We used regression analyses and concentration curves to assess the equity of household costs across age, geographic location, and socio-economic status. The mean societal economic cost of treating suspected malaria was $15.12 (95%CI: 12.83-17.14) per outpatient and $27.21 (95%CI: 20.43-33.99) per inpatient case. Households incurred 81% of outpatient and 72% of inpatient costs. Households bore nearly equal costs of illness, regardless of socio-economic status. A case of malaria cost households in the lowest quintile 26% of per capita monthly consumption, while a malaria case only cost households in the highest quintile 8%. We estimated the societal cost of malaria treatment in Uganda was $577 million (range: $302 million-1.09 billion) in 2021. The cost of malaria remains high in Uganda. Households bear the major burden of these costs. Poorer and richer households incur the same costs per case; this distribution is equal, but not equitable. These results can be applied to parameterize future economic evaluations of malaria control interventions and to evaluate the impact of malaria on Ugandan society, informing resource allocations in malaria prevention.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Who pays to treat malaria, and how much? Analysis of the cost of illness, equity, and economic burden of malaria in Uganda.\",\"authors\":\"Katherine Snyman, Catherine Pitt, Angelo Aturia, Joyce Aber, Samuel Gonahasa, Jane Frances Namuganga, Joaniter Nankabirwa, Emmanuel Arinaitwe, Catherine Maiteki-Sebuguzi, Henry Katamba, Jimmy Opigo, Fred Matovu, Grant Dorsey, Moses R Kamya, Walter Ochieng, Sarah G Staedke\",\"doi\":\"10.1093/heapol/czae093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Case management of malaria in Africa has evolved markedly over the past twenty years and updated cost estimates are needed to guide malaria control policies. We estimated the cost of malaria illness to households and the public health service and assessed the equity of these costs in Uganda. From December 2021 to May 2022, we conducted a costing exercise in eight government-run health centres covering seven sub-regions, collecting health service costs from patient observations, records review, and a time-and-motion study. From November 2021 to January 2022, we gathered data on households' cost of illness from randomly selected households for 614 residents with suspected malaria. Societal costs of illness were estimated and combined with secondary data sources to estimate the total economic burden of malaria in Uganda. We used regression analyses and concentration curves to assess the equity of household costs across age, geographic location, and socio-economic status. The mean societal economic cost of treating suspected malaria was $15.12 (95%CI: 12.83-17.14) per outpatient and $27.21 (95%CI: 20.43-33.99) per inpatient case. Households incurred 81% of outpatient and 72% of inpatient costs. Households bore nearly equal costs of illness, regardless of socio-economic status. A case of malaria cost households in the lowest quintile 26% of per capita monthly consumption, while a malaria case only cost households in the highest quintile 8%. We estimated the societal cost of malaria treatment in Uganda was $577 million (range: $302 million-1.09 billion) in 2021. The cost of malaria remains high in Uganda. Households bear the major burden of these costs. Poorer and richer households incur the same costs per case; this distribution is equal, but not equitable. These results can be applied to parameterize future economic evaluations of malaria control interventions and to evaluate the impact of malaria on Ugandan society, informing resource allocations in malaria prevention.</p>\",\"PeriodicalId\":12926,\"journal\":{\"name\":\"Health policy and planning\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health policy and planning\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/heapol/czae093\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health policy and planning","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/heapol/czae093","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

过去二十年来,非洲的疟疾病例管理发生了显著变化,需要更新成本估算来指导疟疾控制政策。我们估算了疟疾疾病给乌干达家庭和公共卫生服务带来的成本,并评估了这些成本的公平性。2021 年 12 月至 2022 年 5 月,我们在八个政府运营的医疗中心开展了成本核算工作,覆盖七个分区,通过对患者的观察、记录审查和时间运动研究收集医疗服务成本。2021 年 11 月至 2022 年 1 月,我们从随机抽取的 614 户疑似疟疾患者家庭中收集了家庭疾病成本数据。我们估算了社会疾病成本,并结合二手数据来源估算了乌干达疟疾的总经济负担。我们使用回归分析和浓度曲线来评估不同年龄、地理位置和社会经济地位的家庭成本的公平性。治疗疑似疟疾的平均社会经济成本为每个门诊病人 15.12 美元(95%CI:12.83-17.14),每个住院病人 27.21 美元(95%CI:20.43-33.99)。家庭承担了 81% 的门诊费用和 72% 的住院费用。无论社会经济地位如何,家庭承担的疾病费用几乎相等。最低五分位数家庭的疟疾病例花费了人均月消费的 26%,而最高五分位数家庭的疟疾病例花费仅为 8%。我们估计,2021 年乌干达治疗疟疾的社会成本为 5.77 亿美元(范围:3.02 亿-10.9 亿美元)。乌干达的疟疾成本仍然很高。家庭承担了这些费用的主要负担。贫困家庭和富裕家庭在每个病例上的成本相同;这种分配是平等的,但并不公平。这些结果可用于对疟疾控制干预措施的未来经济评估进行参数化,并用于评估疟疾对乌干达社会的影响,为疟疾预防的资源分配提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Who pays to treat malaria, and how much? Analysis of the cost of illness, equity, and economic burden of malaria in Uganda.

Case management of malaria in Africa has evolved markedly over the past twenty years and updated cost estimates are needed to guide malaria control policies. We estimated the cost of malaria illness to households and the public health service and assessed the equity of these costs in Uganda. From December 2021 to May 2022, we conducted a costing exercise in eight government-run health centres covering seven sub-regions, collecting health service costs from patient observations, records review, and a time-and-motion study. From November 2021 to January 2022, we gathered data on households' cost of illness from randomly selected households for 614 residents with suspected malaria. Societal costs of illness were estimated and combined with secondary data sources to estimate the total economic burden of malaria in Uganda. We used regression analyses and concentration curves to assess the equity of household costs across age, geographic location, and socio-economic status. The mean societal economic cost of treating suspected malaria was $15.12 (95%CI: 12.83-17.14) per outpatient and $27.21 (95%CI: 20.43-33.99) per inpatient case. Households incurred 81% of outpatient and 72% of inpatient costs. Households bore nearly equal costs of illness, regardless of socio-economic status. A case of malaria cost households in the lowest quintile 26% of per capita monthly consumption, while a malaria case only cost households in the highest quintile 8%. We estimated the societal cost of malaria treatment in Uganda was $577 million (range: $302 million-1.09 billion) in 2021. The cost of malaria remains high in Uganda. Households bear the major burden of these costs. Poorer and richer households incur the same costs per case; this distribution is equal, but not equitable. These results can be applied to parameterize future economic evaluations of malaria control interventions and to evaluate the impact of malaria on Ugandan society, informing resource allocations in malaria prevention.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信