背景:儿童眼部发病率是一个巨大的公共卫生问题,特别是在低收入国家。这项研究旨在确定孟加拉国三级医院就诊的儿童眼部发病率的经济负担。这项研究还评估了孟加拉国儿童眼部发病率的灾难性健康支出(CHE)。
方法:在2023年4月至10月在孟加拉国的两家三级医院对这项研究采用了横截面混合方法,一个政府资助,一个私人。使用半结构化定量问卷与护理人员/父母进行面对面访谈,并在这两家医院的相同受访者中进行了深度访谈(IDI)。在研究期间,与利益相关者进行了一次研讨会。
结果:这是孟加拉国的第一项研究,以确定小儿眼部发病率的成本。在335名患者中,在政府医院,一次的总直接成本中位数为3740±18,285BDT(34±166.2美元),在私立医院为7300±40,630BDT(66.36±369.36美元).斜视诊断疾病的疾病特异性中位数总成本为65,000BDT(591美元),50,000BDT(454.54美元)用于白内障,和30,000BDT(272.72美元)的眼睛伤害。由于不同的儿科眼部发病率,几乎90%的护理人员/父母面临CHE。
结论:这些成本估算可以用作财务决策的初始基础,旨在增加获得护理的机会,管理,和随访儿童的眼部发病率。这些成本估算还为组织和财务可持续性计划提供了有用的信息。政策制定者可以考虑立即采取严肃的干预措施,以确保孟加拉国的眼部健康服务,并防止家庭遭受CHE。
BACKGROUND: Childhood eye morbidity is a great public health problem, especially in low-income countries. This study aimed to determine the economic burden of childhood ocular morbidity on attending tertiary hospitals in Bangladesh. This study also assessed the catastrophic health expenditure (CHE) for childhood ocular morbidity in Bangladesh.
METHODS: A cross-sectional mixed method was used for this study from April to October 2023 at two tertiary hospitals in Bangladesh, one government-funded and one private. Face-to-face interviews using a semi-structured quantitative questionnaire with the caregivers/parents and in-depth interviews (IDIs) were conducted among the same respondents of these two hospitals, and a workshop was conducted with the stakeholders during the study period.
RESULTS: This was the first study in Bangladesh to determine the cost of pediatric ocular morbidity. Among 335 patients, the total median direct cost at a single time was 3740 ± 18,285 BDT (34 ± 166.2 USD) at the government hospital and 7300 ± 40,630 BDT (66.36 ± 369.36 USD) at the private hospital. The disease-specific median overall cost from diagnosis of the disease was 65,000 BDT (591 USD) for squint, 50,000 BDT (454.54 USD) for cataract, and 30,000 BDT (272.72 USD) for eye injury. Almost 90% of the caregivers/parents faced CHE due to different pediatric ocular morbidity.
CONCLUSIONS: These cost estimates can be used as an initial basis for financial decisions that aim to enhance access to care, management, and follow-up of children with ocular morbidity. These cost estimates also offer helpful information for organizational and financial sustainability initiatives. Policymakers can consider serious immediate interventions for securing ocular health services in Bangladesh and prevent families from CHE.