Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria 英文参考文献.docVIP

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Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria 英文参考文献.doc

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Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria 英文参考文献

ExaminingInequitiesinIncidenceofCatastrophicHealth ExpendituresonDifferentHealthcareServicesand HealthFacilitiesinNigeria ObinnaOnwujekwe1,2*,KaraHanson3,BenjaminUzochukwu1,2,4 1Health Policy Research Group, Department of Pharmacology and Therapeutics, University of Nigeria Enugu-Campus, Enugu, Nigeria, 2Department of Health AdministrationandManagement,UniversityofNigeriaEnugu-Campus,Enugu,Nigeria,3DepartmentofGlobalHealthandDevelopment,LondonSchoolofHygieneand TropicalMedicine,London,UnitedKingdom,4DepartmentofCommunityMedicine,CollegeofMedicine,UniversityofNigeriaEnugu-Campus,Enugu,Nigeria Abstract Objective:Thereislimitedevidenceaboutlevelsofsocio-economicandotherdifferencesincatastrophichealthspendingin Nigeriaandinmanysub-SaharanAfricancountries.Thestudyestimatedthelevelofcatastrophichealthcareexpenditures fordifferenthealthcareservicesandfacilitiesandtheirdistributionacrosssocioeconomicstatus(SES)groups. Methods:ThestudytookplaceinfourLocalGovernmentAreasinsoutheastNigeria.Datawerecollectedusinginterviewer- administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregatedexpenditurebysourceandtypeofcare. Results:Theaveragetotalhouseholdhealthexpenditurepermonthwas2354Naira($19.6).Foroutpatientservices,average monthlyexpenditurewas1809Naira($15.1),whilstforinpatientservicesitwas610Naira($5.1).Higherhealthexpenditures wereincurredbyurbanresidentsandthebetter-offSESgroups.Overall,27%ofhouseholdsincurredCHE,higherforpoorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurancescheme. Conclusion: The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure.Therewasalmostacompletelackoffinancialriskprotection.Healthreformmechanismsareneededtoensure universalcoveragewithfina