ABSTRACT

Objective

To estimate the out-of-pocket (OOP) expenditure and catastrophic expenditure due to stroke-related hospitalization and determine associated predictors.

Methods

Secondary analysis of household-based survey conducted by National Sample Survey Organization from June 2017 to 2018.

Results

A total of 1152 and 407 individuals reported stroke-related hospitalization and outpatient care, respectively, in the survey. Stroke-related hospitalization rate in India is 46 per 100,000 persons. The mean and median expenditure per episode of stroke-related hospitalization was INR 40,360 (US$ 539.75) and INR 17,140 (US$ 229.22), respectively, with significant OOP hospitalization expenditure across wealth quintiles (p < 0.001). About 29% (25–34%) of households seeking stroke treatment in public medical institutions experienced catastrophic expenditure. 37% (34–40%) of households resorted to distress health financing due to stroke-related hospitalization. Medicines accounted on an average 38% and 73% of public sector hospitalization and outpatient care, respectively. Patients treated in a private facility, hospitalized for over 7 days, within the poorest wealth quintiles had higher odds of incurring catastrophic expenditure.

Conclusion

Economic burden associated with stroke-related hospitalization is substantial in India. The publicly funded health insurance scheme should cover expenses on stroke-related medicines to reduce OOP expenditure of patients seeking treatment in public sector facilities.

中文翻译：

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印度与中风相关的经济负担：来自全国抽样调查的见解 2017-18

摘要

客观的

估计因中风相关住院导致的自付费用 (OOP) 支出和灾难性支出，并确定相关的预测因素。

方法

全国抽样调查机构 2017 年 6 月至 2018 年住户调查的二次分析。

结果

在调查中，共有 1152 人和 407 人分别报告了中风相关的住院和门诊治疗。印度的中风相关住院率为每 10 万人 46 人。每次卒中相关住院治疗的平均和中位数支出分别为 40,360 卢比（539.75 美元）和 17,140 卢比（229.22 美元），在财富五分位数中具有显着的 OOP 住院支出（p< 0.001)。约 29%（25-34%）在公立医疗机构寻求中风治疗的家庭经历了灾难性支出。37% (34-40%) 的家庭因中风相关住院而求助于健康融资。药品平均分别占公共部门住院和门诊服务的 38% 和 73%。在私人机构接受治疗、住院超过 7 天、在最贫穷的五分之一中的患者发生灾难性支出的几率更高。

结论

在印度，与中风相关的住院治疗相关的经济负担很大。公共资助的健康保险计划应涵盖中风相关药物的费用，以减少在公共部门设施寻求治疗的患者的自费支出。