PDF(Pubmed)
Abstract：
UNASSIGNED: Diabetes mellitus (DM) is a major public health concern in India, and entails a severe burden in terms of disability, death, and economic cost. This study examined the out-of-pocket health expenditure (OOPE) and financial burden associated with DM care in India.
UNASSIGNED: The study used data from the latest round of the National Sample Survey on health, which covered 555,115 individuals from 113,823 households in India. In the present study, data of 1216 individuals who sought inpatient treatment and 6527 individuals who sought outpatient care for DM were analysed.
UNASSIGNED: In India, 10.04 per 1000 persons reported having DM during the last 15 days before the survey date, varying from 6.94/1000 in rural areas to 17.45/1000 in urban areas. Nearly 38% of Indian households with diabetic members experienced catastrophic health expenditure (at the 10% threshold) and approximately 10% of DM-affected households were pushed below the poverty line because of OOPE, irrespective of the type of care sought. 48.5% of households used distressed sources to finance the inpatient costs of DM. Medicines constituted one of the largest proportion of total health expenditure, regardless of the type of care sought or type of healthcare facility visited. The average monthly OOPE was over 4.5-fold and 2.5-fold higher for households who sought inpatient and outpatient care, respectively, from private health facilities, compared with those treated at public facilities. Notably, the financial burden was more severe for households residing in rural areas, those in lower economic quintiles, those belonging to marginalised social groups, and those using private health facilities.
UNASSIGNED: The burden of DM and its associated financial ramifications necessitate policy measures, such as prioritising health promotion and disease prevention strategies, strengthening public healthcare facilities, improved regulation of private healthcare providers, and bringing outpatient services under the purview of health insurance, to manage the diabetes epidemic and mitigate its financial impact.
UNASSIGNED: The study used data from the latest round of the National Sample Survey on health, which covered 555,115 individuals from 113,823 households in India. In the present study, data of 1216 individuals who sought inpatient treatment and 6527 individuals who sought outpatient care for DM were analysed.
UNASSIGNED: In India, 10.04 per 1000 persons reported having DM during the last 15 days before the survey date, varying from 6.94/1000 in rural areas to 17.45/1000 in urban areas. Nearly 38% of Indian households with diabetic members experienced catastrophic health expenditure (at the 10% threshold) and approximately 10% of DM-affected households were pushed below the poverty line because of OOPE, irrespective of the type of care sought. 48.5% of households used distressed sources to finance the inpatient costs of DM. Medicines constituted one of the largest proportion of total health expenditure, regardless of the type of care sought or type of healthcare facility visited. The average monthly OOPE was over 4.5-fold and 2.5-fold higher for households who sought inpatient and outpatient care, respectively, from private health facilities, compared with those treated at public facilities. Notably, the financial burden was more severe for households residing in rural areas, those in lower economic quintiles, those belonging to marginalised social groups, and those using private health facilities.
UNASSIGNED: The burden of DM and its associated financial ramifications necessitate policy measures, such as prioritising health promotion and disease prevention strategies, strengthening public healthcare facilities, improved regulation of private healthcare providers, and bringing outpatient services under the purview of health insurance, to manage the diabetes epidemic and mitigate its financial impact.
摘要：
■糖尿病（DM）是印度的主要公共卫生问题，在残疾方面带来了沉重的负担，死亡,和经济成本。这项研究调查了印度与DM护理相关的自付医疗支出（OOPE）和经济负担。
■这项研究使用了最新一轮全国健康抽样调查的数据，覆盖了印度113,823户家庭的555,115人。在本研究中,我们分析了1216例寻求住院治疗的患者和6527例寻求门诊治疗的DM患者的数据.
■在印度，调查日期前15天报告患有DM的每1000人10.04人，从农村地区的6.94/1000到城市地区的17.45/1000不等。近38％的有糖尿病成员的印度家庭经历了灾难性的医疗支出（在10％的阈值），并且由于OOPE，大约10％的受DM影响的家庭被推到贫困线以下，无论所寻求的护理类型如何。48.5%的家庭使用不良来源来资助DM的住院费用。药品占卫生总支出的最大比例之一，无论寻求的护理类型或访问的医疗机构类型如何。寻求住院和门诊护理的家庭每月平均OOPE分别高出4.5倍和2.5倍，分别,来自私人医疗机构，与在公共设施接受治疗的人相比。值得注意的是,农村家庭的经济负担更为严重，那些处于较低经济五分之一的人，属于边缘化社会群体的人，以及使用私人医疗设施的人。
■DM的负担及其相关的财务后果需要采取政策措施，例如优先考虑健康促进和疾病预防战略，加强公共医疗设施，改善对私营医疗保健提供者的监管，并将门诊服务纳入健康保险范围，管理糖尿病流行并减轻其财务影响。
■这项研究使用了最新一轮全国健康抽样调查的数据，覆盖了印度113,823户家庭的555,115人。在本研究中,我们分析了1216例寻求住院治疗的患者和6527例寻求门诊治疗的DM患者的数据.
■在印度，调查日期前15天报告患有DM的每1000人10.04人，从农村地区的6.94/1000到城市地区的17.45/1000不等。近38％的有糖尿病成员的印度家庭经历了灾难性的医疗支出（在10％的阈值），并且由于OOPE，大约10％的受DM影响的家庭被推到贫困线以下，无论所寻求的护理类型如何。48.5%的家庭使用不良来源来资助DM的住院费用。药品占卫生总支出的最大比例之一，无论寻求的护理类型或访问的医疗机构类型如何。寻求住院和门诊护理的家庭每月平均OOPE分别高出4.5倍和2.5倍，分别,来自私人医疗机构，与在公共设施接受治疗的人相比。值得注意的是,农村家庭的经济负担更为严重，那些处于较低经济五分之一的人，属于边缘化社会群体的人，以及使用私人医疗设施的人。
■DM的负担及其相关的财务后果需要采取政策措施，例如优先考虑健康促进和疾病预防战略，加强公共医疗设施，改善对私营医疗保健提供者的监管，并将门诊服务纳入健康保险范围，管理糖尿病流行并减轻其财务影响。
