在达卡医院报告前5岁以下腹泻病例的社区一级费用：孟加拉国的横断面分析

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2024-11-15 DOI:10.1016/j.cegh.2024.101846

Md Fuad Al Fidah , Md Ridwan Islam , Md Mushfiqur Rahman , Mohammod Jobayer Chisti , A.S.G. Faruque , Tahmeed Ahmed , Sharika Nuzhat

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引用次数: 0

摘要

背景腹泻病是一项重大的公共卫生挑战，给家庭带来巨大的经济负担。我们的目的是研究在达卡医院就诊前社区发生的直接医疗费用（DMC）、直接非医疗费用（DNMC）和家庭经济负担（FEB）的趋势。方法从孟加拉国国际腹泻病研究中心达卡医院（icddr,b） 2012 - 2021年DDSS数据库中提取sdmc和DNMC。社区的成本是在调整通货膨胀并转换为2022年的国际美元（I$）后计算的。Jonckheere-Terpstra检验检验了趋势，并使用了五分位数回归。结果样本量为14178例。直接成本中位数（IQR）、DMC、DNMC和FEB分别为26.2美元（14.5-44.9）、10.1美元（3.6-21.3）、13.11美元（7.5-22.3）和3.5%（1.8 - 6.9%）。总体增长趋势(2012年为2.9%，2021年为4.3%；p值<；0.001)和最近的下降趋势（从2020年的4.6%开始）在2月份出现，年龄、离家距离、到达医院所需时间、居住在达卡市内、财富指数和中度至重度疾病与所有成本相关。充足的母体媒体接触(系数：0.698；95%CI: 1.167 ~ - 0.229；p值= 0.004)和母亲的中等教育程度(系数：0.316；95% CI:0.018 ~ 0.614；p值= 0.038)呈负相关，病程呈正相关(系数：0.786；95% CI:0.591 ~ 0.981；p值<；0.001)。结论2012 - 2021年feb呈显著趋势。结果表明，需要提高对立即使用口服补液疗法的认识和健康教育，并在需要机构护理时直接向设施寻求护理。

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Community-level expenses for under-5 diarrhoeal cases prior to reporting at Dhaka Hospital: A cross-sectional analysis in Bangladesh

Background

Diarrhoeal diseases are a major public health challenge, placing immense economic burden on households. We aimed to examine the trends in direct medical costs (DMC), direct non-medical costs (DNMC), and family economic burden (FEB) incurred in the community before seeking care at the Dhaka Hospital.

Methods

DMC and DNMC were extracted from the database of the DDSS of Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) from 2012 to 2021. Costs in the community were calculated after adjusting for inflation and converting into international dollars (I$) for 2022. The Jonckheere-Terpstra test examined the trends, and quintile regression was used.

Results

The sample size was 14178. The median (IQR) direct cost, DMC, DNMC and FEB were I$26.2(14.5–44.9), I$10.1(3.6–21.3), I$13.11(7.5–22.3) and 3.5 %(1.8–6.9 %) respectively. An overall increasing trend (2.9 % in 2012 to 4.3 % in 2021; p-value<0.001) and a recent declining trend (from 4.6 % in 2020) were seen in FEB. Age, distance from home, time taken to reach the hospital, living inside Dhaka, wealth index, and moderate-to-severe disease were associated with all costs. Adequate maternal media exposure (coef: 0.698; 95%CI: 1.167 to −0.229; p-value = 0.004) and secondary level education of the mother (coef: 0.316; 95 % CI:0.018 to 0.614; p-value = 0.038) were negatively associated, COVID-19 period was positively associated (coef:0.786; 95 % CI:0.591 to 0.981; p-value<0.001) with FEB.

Conclusion

FEB showed significant trend from 2012 to 2021. The result indicates the need for increased awareness and health education on using immediate oral rehydration therapy and seeking care directly from facilities when institutional care is needed.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.