Out-of-pocket expenditure for hypertension care: a population-based study in low-income urban Medellin, Colombia
| Autor: | Rubén Darío Gómez Arias, Viviana Pérez Ospina, Cecilia Taborda Pérez, Tatiana Margarita Villacres Landeta, Anai García Fariñas, Esteban Londoño Agudelo, Tullia Battaglioli, Patrick Van der Stuyft |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Budgets
Male Latin Americans catastrophic health expenditure Social Sciences Disease Medical care DISEASE chronic diseases Out-of-pocket expenses 0302 clinical medicine Pregnancy Medicine and Health Sciences 030212 general & internal medicine health equity Family Characteristics 030503 health policy & services Health Policy Health Services Middle Aged Health equity Cardiovascular Diseases Research Design Hypertension health insurance Income Female Original Article Public Health Public aspects of medicine RA1-1270 0305 other medical science Research Article Low income Adult medicine.medical_specialty Colombia 03 medical and health sciences Environmental health MANAGEMENT medicine Humans household budgets Poverty Health policy Public health Environmental and Occupational Health Public Health Environmental and Occupational Health ADULTS PREVENTION Population based study primary health care HEALTH-SYSTEMS Cross-Sectional Studies Latin America Chronic Disease Business Health Expenditures |
| Zdroj: | Global Health Action article-version (VoR) Version of Record GLOBAL HEALTH ACTION Global Health Action, Vol 13, Iss 1 (2020) |
| ISSN: | 1654-9880 1654-9716 |
| Popis: | Background Hypertension requires life-long medical care, which may cause economic burden and even lead to catastrophic health expenditure. Objective To estimate the extent of out-of-pocket expenditure for hypertension care at a population level and its impact on households’ budgets in a low-income urban setting in Colombia. Methods We conducted a cross-sectional survey in Santa Cruz, a commune in the city of Medellin. In 410 randomly selected households with a hypertensive adult, we estimated annual basic household expenditure and hypertension-attributable out-of-pocket expenditure. For socioeconomic stratification, we categorised households according to basic expenditure quintiles. Catastrophic hypertension-attributable expenditure was defined as out-of-pocket expenditure above 10% of total household expenditure. Results The average annual basic household expenditure was US dollars at purchasing power parity (USD-PPP) $12,255.59. The average annual hypertension-attributable out-of-pocket expenditure was USD-PPP $147.75 (95% CI 120.93–174.52). It was incurred by 73.9% (95% CI 69.4%-78.1%) of patients, and consisted mainly of direct non-medical expenses (76.7%), predominantly for dietary requirements prescribed as non-pharmacological treatment and for transport to attend health care consultations. Medical out-of-pocket expenditure (23.3%) was for the most part incurred for pharmacological treatment. Hypertension-attributable out-of-pocket expenditure represented on average 1.6% (95% CI 1.3%-1.9%) of the total annual basic household expenditure. Eight households (2.0%; 95% CI 1.0%-3.8%) had catastrophic health expenditure; six of them belonged to the two lowest expenditure quintiles. Payments related to dietary requirements and transport to consultations were critical determinants of their catastrophic expenditure. Conclusions Out-of-pocket expenditure for hypertension care is moderate on average, but frequent, and mainly made up of direct non-medical expenses. Catastrophic health expenditure is uncommon and affects primarily households in the bottom socioeconomic quintiles. Financial protection should be strengthened by covering the costs of chronic diseases-related dietary requirements and transport to health services in the most deprived households. Abbreviations NCDs: Non-communicable diseases; LMICs: Low and middle-income countries; WHO: World Health Organization; HTN: hypertension; CVDs: Cardiovascular diseases; OOPE: out-of-pocket expenditure; USD-PPP: US dollars at purchasing power parity; CI: Confidence interval |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|