印度结核病患者的灾难性成本:方法选择的影响
Susmita Chatterjee1,2,3, Palash Das1, Guy Stallworthy4
1Research Department, George Institute for Global Health, New Delhi, India.
PLOS global public health
|April 26, 2024
概括
结核病 (TB) 的经济负担在印度很高,30%-61%的家庭面临灾难性成本. 诊断和治疗的延迟显著增加了开支,突出了需要生计支持和治疗前费用补偿的需要.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 金融风险保护对于全民健康覆盖至关重要.
- 终结结核病 (TB) 战略的目标是到2020年实现零灾难性成本.
- 之前的印度研究表明,7-32%的结核病受影响的家庭面临灾难性成本,通常基于小规模的横截面数据.
研究的目的:
- 综合评估与印度治疗耐药结核病相关的经济负担和灾难性成本.
- 分析预治疗延迟对家庭财务状况的影响.
- 为结核病患者设计有效的社会保护措施提供证据.
主要方法:
- 在印度四个州跟踪了一组1482名被通知的药物敏感结核病患者.
- 根据世卫组织的指导方针计算治疗费用.
- 人力资本和产出方法都用于估计间接成本 (时间,生产力,收入损失).
主要成果:
- 30%-61%的研究参与者面临灾难性成本,因间接成本计算方法而有所不同.
- 超过一半的患者甚至在开始治疗之前就经历了灾难性成本,因为症状出现的平均时间延迟了7-9周.
- 在诊断前期间,患者进行了8-11次访问,承担了咨询,药物,测试和旅行的费用.
结论:
- 印度有很大一部分结核病患者面临灾难性成本,特别是考虑到收入损失.
- 诊断和开始治疗的延迟是造成这种经济负担的主要原因.
- 专注于减少诊断前延误,吸引私营部门,社区外展和偿还治疗前费用的干预措施对于减轻经济困难至关重要.
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