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Assessing the economic impact of HIV/AIDS on Nigerian households: a propensity score matching approach.

机译：评估艾滋病毒/艾滋病对尼日利亚家庭的经济影响：倾向得分匹配方法。

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OBJECTIVES: We used a novel approach to assess the impact of HIV/AIDS on individuals' healthcare utilization and spending in the Oyo and Plateau states of Nigeria and income foregone from work time lost. METHODS: Data from a 2004 random survey of over 6400 individuals were compared with a sample of 482 individuals living with HIV/AIDS. Estimating the effect of HIV is complicated by the fact that our sample of HIV-positive individuals was non-random; there are selection effects, both in acquiring HIV and being in our sample of HIV-positive people, which was based on contacts through non-governmental organizations. To overcome these, we compared HIV-positive people with a control group with similar observed characteristics, using propensity score matching. The matched HIV-negative individuals had worse health and greater health spending than the full HIV-negative group. This suggests that our HIV sample would not have had 'average' outcomes even if they had not acquired HIV. RESULTS: Compared with our matched control group, HIV is associated with significantly increased morbidity, healthcare utilization, public health facility use, lost work time and family time devoted to care-giving. Direct private healthcare costs and indirect income loss per HIV-positive individual were 36 065 Naira, approximately 56% of annual income per capita in affected households. Approximately 40% of these costs were income losses associated with sickness and care-giving. 10% of the cost of HIV is accounted for by public subsidies for health. The largest single cost, representing 54% of the total economic burden of HIV, is for out-of-pocket expenses for healthcare.
机译：目的：我们使用一种新颖的方法来评估艾滋病毒/艾滋病对尼日利亚奥约州和高原州个人医疗保健的使用和支出以及因工作时间损失而放弃的收入的影响。方法：将2004年对6400多人进行的随机调查的数据与482名艾滋病毒/艾滋病患者的样本进行了比较。由于我们的HIV阳性个体样本是非随机的，因此估算HIV的影响变得很复杂。在获得艾滋病毒方面以及在我们的艾滋病毒呈阳性人群中都有选择效应，这是基于通过非政府组织的接触而得出的。为了克服这些问题，我们使用倾向评分匹配法，将HIV阳性患者与具有相似观察特征的对照组进行了比较。相匹配的艾滋病毒阴性个体比整个艾滋病毒阴性个体的健康状况更差，医疗支出更高。这表明我们的艾滋病毒样本即使没有获得艾滋病毒也不会具有“平均”结果。结果：与我们的配对对照组相比，HIV与发病率，医疗保健利用率，公共卫生设施使用，工作时间损失和专门用于护理的家庭时间显着增加有关。每个艾滋病毒呈阳性者的直接私人医疗保健费用和间接收入损失为3 065奈拉，约占受影响家庭年人均收入的56％。这些费用中约有40％是与疾病和护理有关的收入损失。艾滋病毒费用的10％由公共卫生补贴承担。最大的一笔费用，占艾滋病毒总经济负担的54％，是医疗保健的自付费用。

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