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Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana

机译：调查加纳的父母/照顾者对非传染性疾病儿童的照料负担

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The introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS. We conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers. The study found that over 30?% of parents/caregivers spend more than Gh￠50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40?% of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children. Even though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.
机译：加纳国家健康保险计划（NHIS）的引入已导致对医疗服务利用的逐步显着提高。但是，在NHIS的支持下，尤其是在住院期间，照料非传染性疾病（NCD）儿童的经济负担较少。因此，本文旨在评估加纳NHIS时代父母/照顾者在加纳的非传染性疾病住院儿童照料中所面临的经济负担。我们对在三所医院住院的225名患有NCDS的儿童的父母或照顾者进行了横断面调查。便利抽样用于选择住院后出院的孩子。数据分析中使用了描述性统计数据，例如频率和卡方以及逻辑回归。主要结果变量是护理的财务负担，以住院费用为辅。独立变量包括社会经济和其他指标，例如年龄，性别，收入水平和父母/照顾者面临的经济困难。研究发现，超过30％的父母/照顾者花费超过50格瓦特（25美元）作为治疗患有非传染性疾病的儿童的治疗费用。超过40％的父母/护理人员在为病房提供医疗保健方面也面临经济困难。还发现，尽管许多非传染性疾病住院儿童都受到了国家医疗保险制度的覆盖，而且国家医疗保险制度确实为照顾非传染性疾病儿童的父母提供了巨大的经济救济，但被保险的儿童仍需自付费用尽管具有保险地位，但仍可用于医疗保健。还发现亲属和朋友对照料非传染性疾病住院儿童的支持较少，因此加重了父母/照料者照料儿童的经济负担。尽管事实证明，健康保险可以大大减轻照顾非传染性疾病儿童的财务负担，但父母/照顾者在照料病房方面仍然面临巨大的财务负担。因此，卫生保健提供者应确保所有患有NCD的儿童，包括那些被NHIS排除的儿童，都应被NHIS覆盖。建议作出特别的努力，着重于确定低收入群体中的非传染性疾病儿童，尤其是农村地区的非传染性儿童，以免除他们接受任何形式的医疗保健费用。

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