埃塞俄比亚与结核病相关的灾难性费用。

IF 1.3 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2024-06-01 DOI:10.5588/pha.24.0006
A A Deribew, Z G Dememew, K M Alemu, G Tefera, S G Negash, Y A Molla, A G Woldegiorgis, D G Datiko, P G Suarez
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引用次数: 0

摘要

目标:衡量埃塞俄比亚阿姆哈拉、奥罗莫、南方各族州(SNNP)和锡达玛等 19 个地区在降低结核病相关灾难性费用方面的进展情况:2020 年 11 月至 2021 年 2 月,在 19 个地区内的所有县随机抽取医疗机构进行基线调查。针对基线调查中确定的灾难性成本的主要驱动因素实施了干预措施,如安装 126 台 GeneXpert 和 13 台 Truenat 机器、确保 372 台 GeneXpert 的连接、建立替代标本转诊系统以及卫生工作者的能力建设。2022 年 10 月至 12 月进行了一次后续调查。采用世卫组织通用工具,根据概率与规模成正比的原则收集数据。将数据输入 STATA 软件,计算灾难性费用的比例,并比较两次调查的结果:分别有 433 名和 397 名患者参与了基线调查和随访调查。灾难性费用的比例从 64.7% 降至 43.8%(P < 0.0001)。直接非医疗费用所占比例从 76.2% 降至 19.2%,而医疗和间接费用所占比例分别从 11.6% 和 12.3% 增至 30.4% 和 52.4%:结论:在两年的时间里,面临结核病相关灾难性费用的家庭比例大幅下降。结论:在两年的时间里,面临结核病相关灾难性费用的家庭比例已大幅下降,但这一比例仍然高得令人难以接受,而且各地区之间存在差异。要进一步降低灾难性费用,需要采取多部门应对措施、审查结核病服务豁免政策、进一步下放权力以及提高结核病服务质量。
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TB-related catastrophic costs in Ethiopia.

Objectives: To measure the progress towards reducing TB-related catastrophic costs in 19 zones of Amhara, Oromia, SNNP (Southern Nations and Nationalities, and Peoples) and Sidama Regions of Ethiopia.

Methods: A baseline survey was conducted in randomly selected health facilities from all districts within the 19 zones from November 2020 to February 2021. Interventions targeting the major drivers of catastrophic costs identified in the baseline survey, such as installation of 126 GeneXpert and 13 Truenat machines, securing connectivity of 372 GeneXpert, establishing alternative specimen referral systems, and capacity-building of health workers, were implemented. A follow-up survey was conducted from October to December 2022. The WHO generic tool was used to collect data based on probability proportional to size. Data were entered into STATA software, and the proportion of catastrophic costs was calculated and compared between the two surveys.

Results: A total of 433 and 397 patients participated in the baseline and follow-up surveys, respectively. The proportion of catastrophic costs reduced from 64.7% to 43.8% (P < 0.0001). The share of direct non-medical costs decreased from 76.2% to 19.2%, while medical and indirect costs increased from 11.6% and 12.3% to 30.4% and 52.4 %.

Conclusion: The proportion of households facing TB-related catastrophic costs has significantly reduced over the 2-year period. However, it remains unacceptably high and varies among regions. Further reducing the catastrophic costs requires multisectoral response, reviewing the TB service exemption policy, further decentralisation and improving the quality of TB services.

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来源期刊
Public Health Action
Public Health Action RESPIRATORY SYSTEM-
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29
期刊介绍: Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
期刊最新文献
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