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Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012
BACKGROUND: With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625606/ https://www.ncbi.nlm.nih.gov/pubmed/28969643 http://dx.doi.org/10.1186/s12936-017-2038-y |
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author | Hennessee, Ian Chinkhumba, Jobiba Briggs-Hagen, Melissa Bauleni, Andy Shah, Monica P. Chalira, Alfred Moyo, Dubulao Dodoli, Wilfred Luhanga, Misheck Sande, John Ali, Doreen Gutman, Julie Lindblade, Kim A. Njau, Joseph Mathanga, Don P. |
author_facet | Hennessee, Ian Chinkhumba, Jobiba Briggs-Hagen, Melissa Bauleni, Andy Shah, Monica P. Chalira, Alfred Moyo, Dubulao Dodoli, Wilfred Luhanga, Misheck Sande, John Ali, Doreen Gutman, Julie Lindblade, Kim A. Njau, Joseph Mathanga, Don P. |
author_sort | Hennessee, Ian |
collection | PubMed |
description | BACKGROUND: With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. METHODS: A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June–August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. RESULTS: Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. CONCLUSIONS: Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect households from potentially catastrophic health expenditures. |
format | Online Article Text |
id | pubmed-5625606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56256062017-10-12 Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 Hennessee, Ian Chinkhumba, Jobiba Briggs-Hagen, Melissa Bauleni, Andy Shah, Monica P. Chalira, Alfred Moyo, Dubulao Dodoli, Wilfred Luhanga, Misheck Sande, John Ali, Doreen Gutman, Julie Lindblade, Kim A. Njau, Joseph Mathanga, Don P. Malar J Research BACKGROUND: With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. METHODS: A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June–August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. RESULTS: Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. CONCLUSIONS: Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect households from potentially catastrophic health expenditures. BioMed Central 2017-10-02 /pmc/articles/PMC5625606/ /pubmed/28969643 http://dx.doi.org/10.1186/s12936-017-2038-y Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Hennessee, Ian Chinkhumba, Jobiba Briggs-Hagen, Melissa Bauleni, Andy Shah, Monica P. Chalira, Alfred Moyo, Dubulao Dodoli, Wilfred Luhanga, Misheck Sande, John Ali, Doreen Gutman, Julie Lindblade, Kim A. Njau, Joseph Mathanga, Don P. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title | Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title_full | Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title_fullStr | Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title_full_unstemmed | Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title_short | Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012 |
title_sort | household costs among patients hospitalized with malaria: evidence from a national survey in malawi, 2012 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625606/ https://www.ncbi.nlm.nih.gov/pubmed/28969643 http://dx.doi.org/10.1186/s12936-017-2038-y |
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