凉山彝族自治州艾滋病高流行地区HIV阳性孕产妇家庭灾难性卫生支出分析

Analysis of the catastrophic health expenditure of HIV-positive maternal households in high AIDS endemic areas in Liangshan prefecture

目的:分析凉山彝族自治州(简称“凉山州”)艾滋病高流行地区HIV阳性孕产妇家庭收入及家庭灾难性卫生支出情况。方法:于2018年12月至2019年1月,从凉山州17个县(县级市)中的2个高流行县招募孕产妇,共纳入250名孕产妇,HIV阳性和阴性孕产妇分别有133、117名。问卷调查收集孕产妇个人基本情况、家庭基本情况、2017年家庭年收入、2017年家庭卫生年支出、2017年孕产相关支出等信息,分析家庭灾难性卫生支出发生率及平均差距和相对差距。结果:HIV阳性孕产妇家庭平均年收入为7 000元、家庭卫生平均支出为2 000元,HIV阴性家庭分别为10 000元和3 000元。在15%、25%和40%的界定标准下,HIV阳性孕产妇家庭灾难性卫生支出发生率分别为39.10%、33.83%和27.82%,其平均差距分别为34.84%、31.17%和26.65%;HIV阴性孕产妇家庭灾难性卫生支出发生率分别为38.46%、33.33%和23.93%,其平均差距分别为31.68%、28.35%和24.22%。结论:凉山州艾滋病高疫情地区灾难性卫生支出发生率整体较高且影响严重,其中HIV阳性孕产妇家庭可能更严重。建议加大医疗保险补偿和医疗救助力度,以减少灾难性卫生支出对其的影响。

Objective To analysis the income and expenditure of HIV-positive pregnant women and the catastrophic health expenditure of their households in high AIDS endemic areas in Liangshan prefecture.Methods From December 2018 to January 2019,a total of 250 pregnant women were recruited from 2 of 17 counties in Liangshan Prefecture,including 133 HIV-positive pregnant women and 117 HIV-negative pregnant women.The data,including basic information of pregnant women,basic information of the family,annual family income in 2017,annual family health expenditure in 2017,and maternal and child-related expenditure in 2017,were collected for analyzing the incidence of catastrophic health expenditure in the family.Results The average annual income and average annual health expenditure of HIV-positive pregnant women households were 7000 CNY and 2000 CNY,while those of HIV-negative pregnant women households were 10000 CNY and 3000 CNY,respectively.Based on the criteria of 15%,25%and 40%,the incidence of catastrophic health expenditure of HIV-positive pregnant households was 39.10%,33.83%and 27.82%,with average differences of 34.84%,31.17%and 26.65%,respectively,while that of HIV-negative pregnant women households was 38.46%,33.33%and 23.93%,with average differences of 31.68%,28.35%and 24.22%,respectively.Conclusion The incidence of catastrophic health expenditure of pregnant households in high AIDS endemic areas in Liangshan prefecture is high.The incidence of HIV-positive families is slightly higher than that of HIV-negative families.We suggest that medical insurance compensation in Liangshan prefecture should be improved to reduce the impact of catastrophic health expenditure.