AEGiS-14IAC: Patterns of health care utilisation, expenditure and financing of adults with chronic HIV morbidity: results from Upper-North Thailand.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Patterns of health care utilisation, expenditure and financing of adults with chronic HIV morbidity: results from Upper-North Thailand.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeE9049)

Kongsin S, Watts C, Jiamton S
Faculty of Public Health, Mahidol University, Bangkok, Thailand

BACKGROUND: The study aims to: identify the patterns and duration of health-care use by chronically ill adults and their care-givers; and explore the implications for health care provision and financing.

METHODS: The study was conducted in two districts in Phayao Province, Thailand: one district has active support services (Mueng), the other less active services (Pong). Following initial formative research and an enumeration of all households, a cross-sectional-survey of 600 randomly selected rural households was conducted. The sample consisted of 300 'case' households, that were caring for a chronically ill adults (CIAs), and 300 'control' households, with no morbidity or recent death.

RESULTS: Due to differences in service availability, in both case and control households there were significant differences in households', levels of support services utilisation and household expenditure between Mueng and Pong (except support for children in controls was similar in both districts). The levels of household health expenditure of controls was unexpectedly higher in Mueng than in Pong, but this pattern was not observed in cases - with cases in Pong spending more on health care expenditure than in Mueng. At least three quarters of cases and controls were supported in their health care expenses by low income cards or health care cards, and about one-sixth of households paid these expenses by themselves. Multiple regression suggests that cases in Mueng had a lower per capita health expenditure of CIAs than those in Pong. Households with the highest health expenditure were those that borrowed money for health care, reported having CIA's savings and the household head reported being stressed.

CONCLUSION: The findings highlight the substantial burden that seeking health care places on households with CIAs, and illustrate how even in poor areas there are some CIAs who do not use a low income health card to finance health service use.

Keywords: AEGIS, Health Expenditures, Morbidity, HIV Infections, Family Characteristics, Delivery of Health Care, Income, Health Services, HIV Seropositivity, Thailand, Poverty, Cross-Sectional Studies, Fees and Charges, Budgets, Costs and Cost Analysis, Financing, Personal, Adult, Child, economics, epidemiology, organization & administration

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