Study on contribution of hidden out-of-pocket expenses to household catastrophic expenditure on health in Vietnam
| Project/Area Number |
20K23228
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| Research Category |
Grant-in-Aid for Research Activity Start-up
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| Allocation Type | Multi-year Fund |
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| Review Section |
0908:Society medicine, nursing, and related fields
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| Research Institution | Nagasaki University |
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Principal Investigator |
Aiga Hirotsugu 長崎大学, 熱帯医学・グローバルヘルス研究科, 教授 (20884175)
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| Project Period (FY) |
2020-09-11 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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| Keywords | 医療費 / ベトナム / ユニバーサルヘルスカバレッジ / 保健財政 / 健康保険 |
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| Outline of Research at the Start |
ユニバーサルヘルスカバレッジ（UHC）は、人々が経済的困難を伴わずに医療サービスを利用できる状態を示す。UHC指標として医療費自己負担分（OOP：Out-of-pocket）支出が世帯総支出の25％を超える破滅的医療支出に陥る世帯の比率がある。ベトナムでは入院患者の食事・介助等が家族の責務であるためこれらの『隠れたOOP支出』を『国際定義に基づくOOP支出』に加えた『実質OOP支出』に基づく破滅的医療支出世帯の比率は、従来の値より高いと予想される。本研究では、『隠れたOOP支出』を含む『実質OOP支出』を算出し、破滅的医療支出世帯の過小評価を明らかにし、OOP支出の国際定義に課題提起を試みる。
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| Outline of Final Research Achievements |
Incidence of catastrophic household health expenditure is defined as the proportion of households having spent >10% or >25% of total household expenditure on health . Yet, when calculating out-of-pocket expenses (OOP) expenses, the following hidden expenses have been excluded by WHO: (i) transport costs to/from health facilities; (ii) assistance to inpatients by their household members such as feeding/bathing/toileting/laundry; and (iii) patients’ and their household members’ income loss due to inability to work. There is a concern about possible underestimation of incidence of catastrophic household health expenditure. This study aimed to estimate the magnitude of the underestimation due to exclusion of hidden OOP expenses. A total of 219 households of patients of Phu Tho General Hospital, Vietnam, participated in the study. It was found that the incidence calculated by including hidden OOP expenses was 1.77- 2.17 times significantly higher than that by excluding it.
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| Academic Significance and Societal Importance of the Research Achievements |
ユニバーサルヘルスカバレッジの実現には、破滅的保健支出世帯率をより正確に推定することが重要である。現行の、『隠れたOOP支出』を排除した『国際定義に基づくOOP支出』に拠る破滅的保健支出世帯率の算出は、破滅的保健支出世帯率の有意な過小評価となることが本研究で明らかになった。この分野での先行研究は殆どないだけに、本研究の独創性や意義は高い。また、世界各国における公正な保健医療政策の実現に向けての本研究の貢献度も高いと考えられる。『隠れたOOP支出』をOOPの算出時に取り込むことにより、破滅的保健支出世帯率の過小評価を回避するよう世界保健機関WHOや世界銀行WBに問いかけたいと考える。
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Report
(4 results)
Research Products
(1 results)
