贫困和农村环境对多药耐药结核病灾难性支出的影响:使用倾向性得分匹配的探索性研究
Shweta Sharma1, Parvathy Thampy2, Arun M Kokane2
1Department of Community Medicine, L N Medical College Bhopal, Madhya Pradesh, India.
概括
低收入和农村居住显著增加了印度多药耐药结核病 (MDR-TB) 患者灾难性医疗支出的风险. 营养补充剂和辅助药物是主要的成本驱动因素.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 结核病研究 结核病研究
背景情况:
- 多重耐药结核病 (MDR-TB) 对患者造成了巨大的经济负担,可能导致自付和灾难性支出.
- 了解影响灾难性卫生支出 (CHE) 的因素对于制定有针对性的财政支持战略至关重要.
- 这项研究调查了MDR-TB患者的收入,居住地和CHE之间的关联.
研究的目的:
- 确定收入水平和居住地是否与MDR-TB患者的灾难性医疗支出有关.
- 探索不同社会经济和地理层面的CHE贡献成本的来源,分布和主要组成部分.
- 确定MDR-TB患者的具体成本驱动因素,以告知政策和干预措施.
主要方法:
- 在2017年在印度博帕尔注册的MDR-TB患者中进行了一项横截面研究.
- 用结构化工具收集了社会人口统计,成本和应对策略的数据.
- 倾向性得分匹配 (队列平衡) 用于在分析收入,居住地和CHE (定义为≥20%的家庭收入) 之间的关联时调整共变量.
主要成果:
- 在匹配后,低收入患者患CHE的几率比高收入患者高8.57倍.
- 与城市居民相比,居住在农村地区的患者患CHE的几率高出10倍.
- 营养补充剂和辅助药物构成了所有收入和居住群体中CHE的最大比例.
结论:
- 收入差异和地理因素显著增加了MDR-TB患者灾难性医疗支出的可能性.
- 干预措施应考虑针对低收入和农村MDR-TB患者提供有针对性的财政援助和降低成本的战略.
- 解决营养支持和辅助药物的成本对于减轻MDR-TB治疗的经济困难至关重要.
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