PDF(Pubmed)
Abstract：
BACKGROUND: The study investigated healthcare expenditure from the perspective of cancer patients, to determine the level of Catastrophic Health Expenditure (CHE) and its associated factors.
METHODS: This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data.
RESULTS: The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71-60.78), middle income aOR 4.67 (CI 1.52-14.41), poverty income aOR 4.66 (CI 2.60-8.33), staying far from hospital aOR 2.62 (CI 1.58-4.34), chemotherapy aOR 3.70 (CI 2.01-6.82), radiotherapy aOR 2.99 (CI 1.37-6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48-16.87), health insurance aOR 3.99 (CI 2.31-6.90), without GL aOR 3.38 (CI 2.06-5.40), and without health financial aids aOR 2.94 (CI 1.24-6.96).
CONCLUSIONS: CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.
METHODS: This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data.
RESULTS: The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71-60.78), middle income aOR 4.67 (CI 1.52-14.41), poverty income aOR 4.66 (CI 2.60-8.33), staying far from hospital aOR 2.62 (CI 1.58-4.34), chemotherapy aOR 3.70 (CI 2.01-6.82), radiotherapy aOR 2.99 (CI 1.37-6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48-16.87), health insurance aOR 3.99 (CI 2.31-6.90), without GL aOR 3.38 (CI 2.06-5.40), and without health financial aids aOR 2.94 (CI 1.24-6.96).
CONCLUSIONS: CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.
摘要：
背景：这项研究从癌症患者的角度调查了医疗保健支出，确定灾难性卫生支出(CHE)水平及其相关因素。
方法：这项横断面研究是在三家马来西亚公立医院进行的，即吉隆坡医院，CanselorTuankuMuhriz医院和国家癌症研究所使用多级抽样技术从2020年2月至2021年2月招募630名受访者。CHE被定义为每月医疗支出占家庭总支出的10％以上。使用经过验证的问卷收集相关数据。
结果：CHE水平为54.4%。CHE在印度种族患者中更高（P=0.015），教育水平较低（P=0.001），失业者(P<0.001)，收入较低（P<0.001），贫困者(P<0.001)，远离医院的人(P<0.001)，生活在农村地区(P=0.003)，小户型(P=0.029)，中度癌症持续时间（P=0.030），接受放射治疗（P<0.001），治疗非常频繁（P<0.001），且无保函(GL)(P<0.001)。回归分析确定了CHE的重要预测因子为较低的收入aOR18.63(CI5.71-60.78)，中等收入AOR4.67（CI1.52-14.41），贫困收入AOR4.66（CI2.60-8.33），远离医院AOR2.62（CI1.58-4.34），化疗aOR3.70（CI2.01-6.82），放疗AOR2.99（CI1.37-6.57），联合化疗放疗aOR4.99（CI1.48-16.87），健康保险aOR3.99(CI2.31-6.90)，不含GLaOR3.38(CI2.06-5.40)，在没有健康经济援助的情况下，AOR为2.94（CI1.24-6.96）。
结论：CHE与各种社会人口统计学有关，经济,疾病,治疗和健康保险的存在，马来西亚的GL和健康金融援助变量。
方法：这项横断面研究是在三家马来西亚公立医院进行的，即吉隆坡医院，CanselorTuankuMuhriz医院和国家癌症研究所使用多级抽样技术从2020年2月至2021年2月招募630名受访者。CHE被定义为每月医疗支出占家庭总支出的10％以上。使用经过验证的问卷收集相关数据。
结果：CHE水平为54.4%。CHE在印度种族患者中更高（P=0.015），教育水平较低（P=0.001），失业者(P<0.001)，收入较低（P<0.001），贫困者(P<0.001)，远离医院的人(P<0.001)，生活在农村地区(P=0.003)，小户型(P=0.029)，中度癌症持续时间（P=0.030），接受放射治疗（P<0.001），治疗非常频繁（P<0.001），且无保函(GL)(P<0.001)。回归分析确定了CHE的重要预测因子为较低的收入aOR18.63(CI5.71-60.78)，中等收入AOR4.67（CI1.52-14.41），贫困收入AOR4.66（CI2.60-8.33），远离医院AOR2.62（CI1.58-4.34），化疗aOR3.70（CI2.01-6.82），放疗AOR2.99（CI1.37-6.57），联合化疗放疗aOR4.99（CI1.48-16.87），健康保险aOR3.99(CI2.31-6.90)，不含GLaOR3.38(CI2.06-5.40)，在没有健康经济援助的情况下，AOR为2.94（CI1.24-6.96）。
结论：CHE与各种社会人口统计学有关，经济,疾病,治疗和健康保险的存在，马来西亚的GL和健康金融援助变量。
