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Hidden burden of non-medical spending associated with inpatient care among the poor in Afghanistan
Authors: Mohammad Omar Mashal, Keiko Nakamura, and Masashi Kizuki
Source: International Journal of Public Health, pp 1-11, First online: 18 May 2016, DOI: 10.1007/s00038-016-0833-9
Topic(s): Adult health
Health care utilization
Country: Asia
Published: MAY 2016
Abstract: Objectives To elucidate the household payments required for medical and non-medical spending for inpatient health care and examine the pattern of household payments according to household economic status and the degree of remoteness of the area of residence. Methods The subjects were 5940 individuals included in a nationally representative survey in 2010. Their medical (diagnosis and medicine) and non-medical (accommodation and transportation) expenses for their most recent hospitalization were analyzed. Results Compared with the richest group, the poorest group paid less for diagnosis and medicine (AOR = 0.37, P < 0.001; AOR = 0.78, P = 0.009, respectively), paid similar amounts for accommodation (AOR = 1.19, P = 0.164), and more for transportation (AOR = 2.09, P < 0.001). Residents in urban areas paid less than residents in rural areas for accommodation and transportation (AOR = 0.73, P < 0.001; AOR = 0.58, P < 0.001, respectively). Conclusions Poor households paid less for diagnosis and medicine, but more for transportation related to inpatient care. Non-medical spending for inpatient care among the poor should be considered for affordable and accessible health-care utilization. Keywords Afghanistan, Financial burden, Medical and non-medical payments, Poor