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首页> 外文期刊>Journal of health, population, and nutrition >Out-of-pocket expenditure for seeking health care for sick children younger than 5?years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012
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Out-of-pocket expenditure for seeking health care for sick children younger than 5?years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012

机译：孟加拉国5岁以下患病儿童寻求卫生保健的现金支出：2009年和2012年横断面调查的结果

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Background Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. Methods Cross-sectional data was collected by structured questionnaire in 2009 ( n =?7362) and 2012 ( n =?6896) from mothers of the under-five children. OPE included consultation fees and costs of medicine, diagnostic tests, hospital admission, transport, accommodation, and food. Expenditure is expressed in US dollars and adjusted for inflation. Linear regression was used for ascertaining the determinants of OPE. Results Between 2009 and 2012, the median OPE for seeking care for a sick under-five child increased by ~?50%, from USD 0.82 (interquartile range 0.39–1.49) to USD 1.22 (0.63–2.36) per child/visit. Increases were observed in every component OPE measured, except for consultation fees which decreased by 12%. Medicine contributed the major portion of overall OPE. Higher overall OPE for care seeking was associated with a priority illness (20% increase), care from trained providers (90% public/~?2-fold private), residing in hilly/wet lands areas (20%), and for mothers with a secondary education (19%). Conclusion OPE is a major barrier to quality health care services and access to appropriate medicine is increasing in rural Bangladesh. To support the goal of universal health care coverage, geographic imbalances as well as expanded health financing options need to be explored. Electronic supplementary material The online version of this article (10.1186/s41043-017-0110-4) contains supplementary material, which is available to authorized users.
机译：背景技术孟加拉国致力于全民健康覆盖，并且正在探索减少家庭自付费用（OPE）的选择。了解OPE的决定因素是必不可少的步骤。这项研究旨在评估和确定在为五岁以下患病儿童寻求医疗保健方面的OPE决定因素。方法采用结构性问卷调查的方法，分别从2009年（n = 7362）和2012年（n = 6898）的五岁以下儿童的母亲那里收集数据。 OPE包括咨询费和药品，诊断测试，住院，交通，住宿和食物的费用。支出以美元表示，并根据通货膨胀进行调整。线性回归用于确定OPE的决定因素。结果在2009年至2012年之间，为五岁以下患病儿童寻求医疗服务的OPE中位数增加了约50％，从每名儿童/每次访问0.82美元（四分位间距0.39-1.49）增加到1.22美元（0.63-2.36美元）。除咨询费减少了12％外，观察到的每个组成部分OPE均增加了。医学占整个OPE的主要部分。寻求护理的总体OPE较高与以下疾病有关：优先疾病（增加20％），训练有素的提供者的护理（90％的公共/〜2倍私人护理），居住在丘陵/湿地地区（20％）以及母亲受过中等教育（19％）。结论OPE是阻碍高质量医疗服务的主要障碍，孟加拉国农村地区获得适当药物的机会正在增加。为了支持全民医疗覆盖的目标，需要探索地理失衡以及扩大的医疗筹资选择。电子补充材料本文的在线版本（10.1186 / s41043-017-0110-4）包含补充材料，授权用户可以使用。

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