The economic burden of pediatric gastroenteritis to Bolivian families: a cross-sectional study of correlates of catastrophic cost and overall cost burden

BMC Public Health

Juan S Leon⁴  Volga Iñiguez⁵  Remy Zumaran²  Ángel Veizaga³  Carlos Terán⁹  Luis Tamayo^1,10  Rolando Pinto^1,11  Edgar Chavez³  Beatriz Cañipa²  Maria del Carmen Calderón⁸  Paulina A Rebolledo¹  Rebecca Moritz Dahl⁷  Emily R Smith⁷  Rachel M Burke⁶ 

[1] Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA;Hospital Materno-Infantil, La Paz, Bolivia;Hospital Boliviano Holandés, El Alto, Bolivia;Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA;Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, La Paz, Bolivia;Laney Graduate School, Emory University, Atlanta, GA, USA;Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA;Hospital Mario Ortiz Suárez, Santa Cruz, Bolivia;Centro Pediatría, Hospital Albina R. Patiño, Cochabamba, Bolivia;Hospital del Niño, La Paz, Bolivia;Hospital del Niño Manuel Ascencio Villarroel, Cochabamba, Bolivia

关键词: Health economics;    Societal costs;    Diarrhea;    Pediatric gastroenteritis;   

Others  :  1129117
DOI  :  10.1186/1471-2458-14-642

 received in 2013-07-17, accepted in 2014-05-27,  发布年份 2014

【 摘 要 】

Background

Worldwide, acute gastroenteritis causes substantial morbidity and mortality in children less than five years of age. In Bolivia, which has one of the lower GDPs in South America, 16% of child deaths can be attributed to diarrhea, and the costs associated with diarrhea can weigh heavily on patient families. To address this need, the study goal was to identify predictors of cost burden (diarrhea-related costs incurred as a percentage of annual income) and catastrophic cost (cost burden ≥ 1% of annual household income).

Methods

From 2007 to 2009, researchers interviewed caregivers (n = 1,107) of pediatric patients (<5 years old) seeking treatment for diarrhea in six Bolivian hospitals. Caregivers were surveyed on demographics, clinical symptoms, direct (e.g. medication, consult fees), and indirect (e.g. lost wages) costs. Multivariate regression models (n = 551) were used to assess relationships of covariates to the outcomes of cost burden (linear model) and catastrophic cost (logistic model).

Results

We determined that cost burden and catastrophic cost shared the same significant (p < 0.05) predictors. In the logistic model that also controlled for child sex, child age, household size, rural residence, transportations taken to the current visit, whether the child presented with complications, and whether this was the child’s first episode of diarrhea, significant predictors of catastrophic cost included outpatient status (OR 0.16, 95% CI [0.07, 0.37]); seeking care at a private hospital (OR 4.12, 95% CI [2.30, 7.41]); having previously sought treatment for this diarrheal episode (OR 3.92, 95% CI [1.64, 9.35]); and the number of days the child had diarrhea prior to the current visit (OR 1.14, 95% CI [1.05, 1.24]).

Conclusions

Our analysis highlights the economic impact of pediatric diarrhea from the familial perspective and provides insight into potential areas of intervention to reduce associated economic burden.

【 授权许可】

   
2014 Burke et al.; licensee BioMed Central Ltd.

【 图 表 】

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