Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia
Objective: We aimed to estimate out-of-pocket (OOP) health expenditures and the indirect costs related to prenatal check-ups in pregnant women seen in a maternity hospital in the Colombian Caribbean region. Methods: We described the economic costs of pregnant women, with no age limits, who attended...
- Autores:
-
ALVIS-ZAKZUK, NELSON J.
Chaparro-Narváez, Pablo
Díaz-Jiménez, D
Gutiérrez Clavijo, Juan Camilo
CASTILLO RODRIGUEZ, LILIANA
edna estrada, francisco
Castañeda-Orjuela, Carlos
DE LA HOZ RESTREPO, FERNANDO
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2022
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/9328
- Acceso en línea:
- https://hdl.handle.net/11323/9328
https://doi.org/10.2147/CEOR.S274379
https://repositorio.cuc.edu.co/
- Palabra clave:
- Out-of-pocket
Cost-analysis
Prenatal care
Colombia
- Rights
- openAccess
- License
- © 2022 Alvis-Zakzuk et al. This work is published and licensed by Dove Medical Press Limited.
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Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| title |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| spellingShingle |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia Out-of-pocket Cost-analysis Prenatal care Colombia |
| title_short |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| title_full |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| title_fullStr |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| title_full_unstemmed |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| title_sort |
Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, Colombia |
| dc.creator.fl_str_mv |
ALVIS-ZAKZUK, NELSON J. Chaparro-Narváez, Pablo Díaz-Jiménez, D Gutiérrez Clavijo, Juan Camilo CASTILLO RODRIGUEZ, LILIANA edna estrada, francisco Castañeda-Orjuela, Carlos DE LA HOZ RESTREPO, FERNANDO |
| dc.contributor.author.spa.fl_str_mv |
ALVIS-ZAKZUK, NELSON J. Chaparro-Narváez, Pablo Díaz-Jiménez, D Gutiérrez Clavijo, Juan Camilo CASTILLO RODRIGUEZ, LILIANA edna estrada, francisco Castañeda-Orjuela, Carlos DE LA HOZ RESTREPO, FERNANDO |
| dc.subject.proposal.eng.fl_str_mv |
Out-of-pocket Cost-analysis Prenatal care |
| topic |
Out-of-pocket Cost-analysis Prenatal care Colombia |
| dc.subject.proposal.spa.fl_str_mv |
Colombia |
| description |
Objective: We aimed to estimate out-of-pocket (OOP) health expenditures and the indirect costs related to prenatal check-ups in pregnant women seen in a maternity hospital in the Colombian Caribbean region. Methods: We described the economic costs of pregnant women, with no age limits, who attended prenatal check-ups in a maternity hospital. To estimate OOP and indirect costs owing to prenatal check-ups in pregnant women, a survey was constructed, where the woman was asked about some sociodemographic variables, to characterize those attending the prenatal check-ups. Absolute and relative frequencies, averages and confidence intervals were used to characterize the population and estimate OOP and indirect costs in pregnant women. The latter were estimated from the percentile method. A bootstrapping was performed to reduce the bias within the analysis. Results: In total, 56 pregnant women were surveyed, with an average age of 25.9 years (±6.2). All women surveyed had OOP associated to the prenatal check-up in at least one costitem, and the OOP ranged between $0.3 and $108.7. Transportation was the item with the highest frequency of expenses, followed by food, other expenses, and drugs. The mean of OOP expenditures was $24.3 (CI 95% $18.1–31.4) for women who attended their prenatal check-up. Discussion: Considering the estimated OOP health expenditures caused by prenatal checkups by household income, women living with 2–3 minimum wages, these proportions were 5%, 3%, respectively. Unfortunately, this makes prenatal care a significant source of economic burden, impacting poor households in Cartagena. |
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2022 |
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2022-07-01T20:49:08Z |
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2022-07-01T20:49:08Z |
| dc.date.issued.none.fl_str_mv |
2022-02-02 |
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Artículo de revista |
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Alvis-Zakzuk NJ, Díaz-Jiménez D, Chaparro-Narváez P, Gutiérrez-Clavijo JC, Castillo-Rodríguez L, Edna-Estrada F, Castañeda-Orjuela C, De La Hoz-Restrepo F. Substantial Out-of-Pocket Health Expenditure on Prenatal Check-Ups: Estimates from a Sample of Pregnant Women in Cartagena, Colombia. Clinicoecon Outcomes Res. 2022;14:51-60 https://doi.org/10.2147/CEOR.S274379 |
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1178-6981 |
| dc.identifier.uri.spa.fl_str_mv |
https://hdl.handle.net/11323/9328 |
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https://doi.org/10.2147/CEOR.S274379 |
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10.2147/CEOR.S274379 |
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Corporación Universidad de la Costa |
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REDICUC - Repositorio CUC |
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https://repositorio.cuc.edu.co/ |
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Alvis-Zakzuk NJ, Díaz-Jiménez D, Chaparro-Narváez P, Gutiérrez-Clavijo JC, Castillo-Rodríguez L, Edna-Estrada F, Castañeda-Orjuela C, De La Hoz-Restrepo F. Substantial Out-of-Pocket Health Expenditure on Prenatal Check-Ups: Estimates from a Sample of Pregnant Women in Cartagena, Colombia. Clinicoecon Outcomes Res. 2022;14:51-60 https://doi.org/10.2147/CEOR.S274379 1178-6981 10.2147/CEOR.S274379 Corporación Universidad de la Costa REDICUC - Repositorio CUC |
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https://hdl.handle.net/11323/9328 https://doi.org/10.2147/CEOR.S274379 https://repositorio.cuc.edu.co/ |
| dc.language.iso.none.fl_str_mv |
eng |
| language |
eng |
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ClinicoEconomics and Outcomes Research |
| dc.relation.references.spa.fl_str_mv |
1. Organización Mundial de la Salud. ODM 5: mejorar la salud materna; 2018. Available from: https://www.who.int/es/news-room/fact-sheets/detail/millennium-development-goals-(mdgs). Accessed January 6, 2022. 2. GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990 – 2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1775–1812. doi:10.1016/S0140-6736(16)31470-2 3. Cáceres-Manrique FDM. El control prenatal: una reflexión urgente. Rev Colomb Obstet Ginecol. 2009;60(2):165–170. doi:10.18597/ rcog.342 4. Sánchez-Nuncio HR, Pérez-Toga G, Pérez-Rodríguez P, VázquezNava F. Impacto del control prenatal en la morbilidad y mortalidad neonatal [Impact of the prenatal care in the neonatal morbidity and mortality]. Rev Med Inst Mex Seguro Soc. 2005;43(5):377–380. 5. UNICEF. Antenatal care. Available from: https://data.unicef.org/ topic/maternal-health/antenatal-care/. 6. Ministerio de Salud y Proteccion Social. Plan Decenal de Salud Pública Colombia PDSP 2012–2021. [Ministry of Health and Social Protection. Ten-Year Public Health Plan Colombia PDSP 2012–2021]. Bogotá D.C: Ministerio de Salud y Protección Social; 2013. 7. Sandoval-Vargas Y, Eslava-Schmalbach J, Quiroga-Villalobos EF, Pinzón-Villate GY. Inequidades en mortalidad materna por departamentos en Colombia para los años (2000–2001), (2005–2006) y (2008–2009) [Inequities in maternal mortality by departments in Colombia for the years (2000–2001), (2005–2006) and (2008–2009)]. Rev Salud Pública. 2013;15(4):577–589. 8. Nájera Arregocés S, Tuesca Molina R. Desigualdades y características sociodemográficas de la mortalidad materna. Rev Panam Salud Publica [Inequalities and sociodemographic characteristics of maternal mortality in La Guajira, Colombia, 2010-2012]. 2015;37(4):239–244. 9. Vian T, Feeley FG, Domente S, Negruta A, Matei A, Habicht J. Barriers to universal health coverage in Republic of Moldova: a policy analysis of formal and informal out-of-pocket payments. BMC Health Serv Res. 2015;15. doi:10.1186/s12913-015-0984-z 10. Govil D, Purohit N, Gupta SD, Mohanty SK. Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India. J Health Popul Nutr. 2016;35(15):1–11. doi:10.1186/s41043-016-0051-3 11. Ministerio de Salud y Protección Social. Cifras Financieras Del Sector Salud. Notas Conceptuales y Metodológicas Sobre La Medición Del Gasto de Bolsillo En Salud [Financial data of the Health Sector. Conceptual and Methodological Notes on the Measurement of Out-of-Pocket Expenditure on Health]. Vol. 2357. Bogotá D.C.: Ministerio de Salud y Protección Social; 2015. 12. Pisu M, Azuero A, McNees P, Burkhardt J, Benz R, Meneses K. The out of pocket cost of breast cancer survivors: a review. J Cancer Surviv. 2010;4:202–209. doi:10.1007/s11764-010-0125-y 13. Palmquist RB. Valuing localized externalities. In: Revealed Preference Approaches to Environmental Valuation Volumes I and II. Routledge; 2020:81. 14. Ministerio de Salud y Protección Social. Comportamiento del aseguramiento [Behavior of the assurance]; 2018. Available from: https://www.minsalud.gov.co/proteccionsocial/Regimensubsidiado/Paginas/coberturas-del-regimen-subsidiado.aspx. Accessed January 6, 2022. 15. Guerrero R, En MC, Isabel Gallego A. Sistema de salud de Colombia [Health system in Colombia]. Vol. 53. Salud Pública de México; 2020. Available from: https://saludpublica.mx/index.php/spm/article/view/5036. Accessed January 6, 2022. 16. Instituto Nacional de Salud - Observatorio Nacional de Salud [National Health Observatory]. Acceso a Servicios de Salud en Colombia [Health system in Colombia]. Bogotá, DC: Décimo Prim Inf Técnico; 2019. 17. Cantillo-García V, Guzman LA, Arellana J. Socioeconomic Strata as Proxy Variable for Household Income in Transportation Research. Evaluation for Bogotá, Medellín, Cali and Barranquilla. DYNA; 2019. 18. Banco de la República de Colombia. Tasa Representativa del Mercado (TRM) [Representative Market Rate (TRM)]; 2020. Available from: https://www.banrep.gov.co/es/estadisticas/trm. Accessed January 6, 2022. 19. Ministry of Health and Social Protection. Resolution Number 8430 of 1993. 20. World Health Organization. Distribution of health spending and catastrophic spending: methodology Discuss Pap. 2005;2(1):12. 21. Cylus J, Thomson S, Evetovits T. Catastrophic health spending in Europe: equity and policy implications of different calculation methods. Bull World Health Organ. 2018;96(9):599–609. doi:10.2471/BLT.18.209031 22. Myint ANM, Liabsuetrakul T, Htay TT, Wai MM, Sundby J, Bjertness E. Impoverishment and catastrophic expenditures due to out-of-pocket payments for antenatal and delivery care in Yangon Region, Myanmar: a cross-sectional study. BMJ Open. 2018;8 (11):1–8. doi:10.1136/bmjopen-2018-022380 23. Zhong Z, Wei H, Yang L, Yao T, Mao Z, Sun Q. Catastrophic health expenditure: a comparative analysis of smoking and non-smoking households in China. PLoS One. 2020;15(5):e0233749. doi:10.1371/journal.pone.0233749 24. IETS-Cinets. Guías de Práctica Clínica para la prevención, detección temprana y tratamiento de las complicaciones del embarazo, parto o puerperio. 2013. [Clinical Practice Guidelines for the prevention, early detection and treatment of complications of pregnancy, childbirth or the puerperium. 2013] 25. Miller CA. Maternal and infant care: comparisons between Western Europe and the United States. Int J Health Serv. 1993;23(4):655–664. doi:10.2190/RR4G-NTB1-L229-FVHG 26. Delvaux T, Buekens P, Godin I, Boutsen M. Barriers to prenatal care in Europe. Am J Prev Med. 2001;21(1):52–59. doi:10.1016/S0749- 3797(01)00315-4 27. Bernal-Aguirre C, Carvajal-Sierra H, Alvis-Zakzuk NJ. Costos económicos de la infección respiratoria aguda en un Municipio de Colombia Economic costs of acute respiratory infection in a municipality of Colombia [Economic costs of acute respiratory infection in a municipality of Colombia]. Revista de La Universidad Industrial de Santander Salud. 2017;49(3):470–477. doi:10.18273/revsal.v49n3-2017005 28. Alvis-Zakzuk NJ, Díaz-Jiménez D, Castillo-Rodríguez L, et al. Economic costs of chikungunya virus in Colombia. Value Health Reg Issues. 2018;17:32–37. doi:10.1016/j.vhri.2018.01.004 29. Cartagena cómo vamos. Informe de calidad de vida 2015 [how are we doing? Quality of life report 2015]; 2015. Available from: http://www. cartagenacomovamos.org/nuevo/wp-content/uploads/2016/07/Presentación-ICV-2015-Cartagena-Cómo-Vamos.pdf. Accessed January 6, 2022. 30. Cartagena cómo vamos.¿Para dónde vamos? Informe de calidad de vida 2018 [how are we doing? Where are we going? Quality of life report 2018]. Módulo pobreza; 2018. Available from: http://www.cartagenaco movamos.org/nuevo/wp-content/uploads/2019/09/Informe-Calidad-deVida-2018-Módulo-Pobreza.pdf. Accessed January 6, 2022. 31. Etikan I. Comparison of convenience sampling and purposive sampling. Am J Theor Appl Stat. 2016;5:1. doi:10.11648/j.ajtas.20160501.11 32. Sen A. ¿Por qué la equidad en salud? [Why should there be equity in health?] Rev Panam Salud Publica. 2002;11:302–309. doi:10.1590/S1020-49892002000500005 33. Alvis-Estrada L, Alvis-Guzmán N, De La Hoz F. Gasto privado en salud de los hogares de Cartagena de Indias, 2004 [Household spending on private health care in Cartagena de Indias, 2004]. Rev Salud Publica. 2007;9(1):11–25. doi:10.1590/S0124-00642007000100003 34. Alvis-Zakzuk N, Gutierrez-Clavijo J, Castillo-Rodríguez L, et al. PIH11 out-of-pocket health expenditures related to prenatal care: evidence from Colombia, 2018. Value Health. 2020;23:S153. doi:10.1016/j.jval.2020.04.407 |
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ALVIS-ZAKZUK, NELSON J.Chaparro-Narváez, PabloDíaz-Jiménez, DGutiérrez Clavijo, Juan CamiloCASTILLO RODRIGUEZ, LILIANAedna estrada, franciscoCastañeda-Orjuela, CarlosDE LA HOZ RESTREPO, FERNANDO2022-07-01T20:49:08Z2022-07-01T20:49:08Z2022-02-02Alvis-Zakzuk NJ, Díaz-Jiménez D, Chaparro-Narváez P, Gutiérrez-Clavijo JC, Castillo-Rodríguez L, Edna-Estrada F, Castañeda-Orjuela C, De La Hoz-Restrepo F. Substantial Out-of-Pocket Health Expenditure on Prenatal Check-Ups: Estimates from a Sample of Pregnant Women in Cartagena, Colombia. Clinicoecon Outcomes Res. 2022;14:51-60 https://doi.org/10.2147/CEOR.S2743791178-6981https://hdl.handle.net/11323/9328https://doi.org/10.2147/CEOR.S27437910.2147/CEOR.S274379Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Objective: We aimed to estimate out-of-pocket (OOP) health expenditures and the indirect costs related to prenatal check-ups in pregnant women seen in a maternity hospital in the Colombian Caribbean region. Methods: We described the economic costs of pregnant women, with no age limits, who attended prenatal check-ups in a maternity hospital. To estimate OOP and indirect costs owing to prenatal check-ups in pregnant women, a survey was constructed, where the woman was asked about some sociodemographic variables, to characterize those attending the prenatal check-ups. Absolute and relative frequencies, averages and confidence intervals were used to characterize the population and estimate OOP and indirect costs in pregnant women. The latter were estimated from the percentile method. A bootstrapping was performed to reduce the bias within the analysis. Results: In total, 56 pregnant women were surveyed, with an average age of 25.9 years (±6.2). All women surveyed had OOP associated to the prenatal check-up in at least one costitem, and the OOP ranged between $0.3 and $108.7. Transportation was the item with the highest frequency of expenses, followed by food, other expenses, and drugs. The mean of OOP expenditures was $24.3 (CI 95% $18.1–31.4) for women who attended their prenatal check-up. Discussion: Considering the estimated OOP health expenditures caused by prenatal checkups by household income, women living with 2–3 minimum wages, these proportions were 5%, 3%, respectively. Unfortunately, this makes prenatal care a significant source of economic burden, impacting poor households in Cartagena.10 páginasapplication/pdfengDove Medical Press LimitedNew Zealand© 2022 Alvis-Zakzuk et al. This work is published and licensed by Dove Medical Press Limited.Atribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Substantial out-of-pocket health expenditure on prenatal check-ups: estimates from a sample of pregnant women in Cartagena, ColombiaArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85https://www.dovepress.com/substantial-out-of-pocket-health-expenditure-on-prenatal-check-ups-est-peer-reviewed-fulltext-article-CEORCartagenaColombiaClinicoEconomics and Outcomes Research1. Organización Mundial de la Salud. ODM 5: mejorar la salud materna; 2018. Available from: https://www.who.int/es/news-room/fact-sheets/detail/millennium-development-goals-(mdgs). Accessed January 6, 2022.2. GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990 – 2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1775–1812. doi:10.1016/S0140-6736(16)31470-23. Cáceres-Manrique FDM. El control prenatal: una reflexión urgente. Rev Colomb Obstet Ginecol. 2009;60(2):165–170. doi:10.18597/ rcog.3424. Sánchez-Nuncio HR, Pérez-Toga G, Pérez-Rodríguez P, VázquezNava F. Impacto del control prenatal en la morbilidad y mortalidad neonatal [Impact of the prenatal care in the neonatal morbidity and mortality]. Rev Med Inst Mex Seguro Soc. 2005;43(5):377–380.5. UNICEF. Antenatal care. Available from: https://data.unicef.org/ topic/maternal-health/antenatal-care/.6. Ministerio de Salud y Proteccion Social. Plan Decenal de Salud Pública Colombia PDSP 2012–2021. [Ministry of Health and Social Protection. Ten-Year Public Health Plan Colombia PDSP 2012–2021]. Bogotá D.C: Ministerio de Salud y Protección Social; 2013.7. Sandoval-Vargas Y, Eslava-Schmalbach J, Quiroga-Villalobos EF, Pinzón-Villate GY. Inequidades en mortalidad materna por departamentos en Colombia para los años (2000–2001), (2005–2006) y (2008–2009) [Inequities in maternal mortality by departments in Colombia for the years (2000–2001), (2005–2006) and (2008–2009)]. Rev Salud Pública. 2013;15(4):577–589.8. Nájera Arregocés S, Tuesca Molina R. Desigualdades y características sociodemográficas de la mortalidad materna. Rev Panam Salud Publica [Inequalities and sociodemographic characteristics of maternal mortality in La Guajira, Colombia, 2010-2012]. 2015;37(4):239–244.9. Vian T, Feeley FG, Domente S, Negruta A, Matei A, Habicht J. Barriers to universal health coverage in Republic of Moldova: a policy analysis of formal and informal out-of-pocket payments. BMC Health Serv Res. 2015;15. doi:10.1186/s12913-015-0984-z10. Govil D, Purohit N, Gupta SD, Mohanty SK. Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India. J Health Popul Nutr. 2016;35(15):1–11. doi:10.1186/s41043-016-0051-311. Ministerio de Salud y Protección Social. Cifras Financieras Del Sector Salud. Notas Conceptuales y Metodológicas Sobre La Medición Del Gasto de Bolsillo En Salud [Financial data of the Health Sector. Conceptual and Methodological Notes on the Measurement of Out-of-Pocket Expenditure on Health]. Vol. 2357. Bogotá D.C.: Ministerio de Salud y Protección Social; 2015.12. Pisu M, Azuero A, McNees P, Burkhardt J, Benz R, Meneses K. The out of pocket cost of breast cancer survivors: a review. J Cancer Surviv. 2010;4:202–209. doi:10.1007/s11764-010-0125-y13. Palmquist RB. Valuing localized externalities. In: Revealed Preference Approaches to Environmental Valuation Volumes I and II. Routledge; 2020:81.14. Ministerio de Salud y Protección Social. Comportamiento del aseguramiento [Behavior of the assurance]; 2018. 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