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The immediate economic impact of maternal deaths on rural Chinese households.

Ye F, Wang H, Huntington D, Zhou H, Li Y, You F, Li J, Cui W, Yao M, Wang Y, Study team for Economic Impact of Maternal Deaths in Chi - PLoS ONE (2012)

Bottom Line: The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001).The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal and Child Health, School of Public Health, Peking University Beijing, Beijing, China.

ABSTRACT

Objective: To identify the immediate economic impact of maternal death on rural Chinese households.

Methods: Results are reported from a study that matched 195 households who had suffered a maternal death to 384 households that experienced a childbirth without maternal death in rural areas of three provinces in China, using quantitative questionnaire to compare differences of direct and indirect costs between two groups.

Findings: The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001). More than 40% of the direct costs were attributed to funeral expenses. Hospitalization and emergency care expenses were the largest proportion of non-funeral direct costs and were higher in households with maternal death than the comparison group (US$2,248 vs. $305, p<0.001). To cover most of the high direct costs, 44.1% of affected households utilized compensation from hospitals, and the rest affected households (55.9%) utilized borrowing money or taking loans as major source of money to offset direct costs. The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.

Conclusion: The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

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Related in: MedlinePlus

Non-funeral direct costs for households with maternal death.Note: costs presented here are sub-group analysis based on the affected group (n = 195); 48 cases were missing in category of delivery type (48 women in affected group died before childbirth and no delivery type was concerned); 74 cases were missing in category of whether the newborn received emergency treatment(48 women in affected group died before childbirth, 24 cases were stillbirths, and 2 cases were unknown); 78 cases were missing in category of whether the newborn was specially treated in hospital (48 women in affected group died before childbirth, 24 cases were stillbirths, and 6 cases were unknown).
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pone-0038467-g001: Non-funeral direct costs for households with maternal death.Note: costs presented here are sub-group analysis based on the affected group (n = 195); 48 cases were missing in category of delivery type (48 women in affected group died before childbirth and no delivery type was concerned); 74 cases were missing in category of whether the newborn received emergency treatment(48 women in affected group died before childbirth, 24 cases were stillbirths, and 2 cases were unknown); 78 cases were missing in category of whether the newborn was specially treated in hospital (48 women in affected group died before childbirth, 24 cases were stillbirths, and 6 cases were unknown).

Mentions: Direct costs were assessed as the household’s out-of-pocket expenditures associated with maternal death or childbirth (Table 2). The total direct costs with maternal death were more than ten times higher than those without maternal death (US$4,119 vs. $370, p<0.001). Funeral costs made up the largest category of the direct costs for the affected group (US$1,654). The non-funeral direct costs were quite substantial in affected group (US$2,464) and were more than six times higher than in comparison group (US$370)(p<0.001), reflecting the difference in hospitalization and emergency costs (US$2,248/case of maternal death versus US$305/case of childbirth without maternal death). Excluding 12 outliers (8 in affected group and 4 in unaffected group) higher than 3 SDs of mean, direct costs were still significantly higher in affected group compared with unaffected group (mean $3446 vs. $312, median $2452 vs. $224, p<0.001). We conducted multi-variable linear regression to control for possible confounders, including province, age of the mother, whether the mother was literate, whether the mother had pregnancy complications etc. The results showed that after controlling these characteristics, the non-funeral direct costs were still significantly higher in affected group, and the ratio between two groups increased slightly (3.32 vs. 3.46) (see Table S1). The non-funeral direct costs were principally for intensive care for the maternal and newborn, and referral expenses (Figure 1).


The immediate economic impact of maternal deaths on rural Chinese households.

Ye F, Wang H, Huntington D, Zhou H, Li Y, You F, Li J, Cui W, Yao M, Wang Y, Study team for Economic Impact of Maternal Deaths in Chi - PLoS ONE (2012)

Non-funeral direct costs for households with maternal death.Note: costs presented here are sub-group analysis based on the affected group (n = 195); 48 cases were missing in category of delivery type (48 women in affected group died before childbirth and no delivery type was concerned); 74 cases were missing in category of whether the newborn received emergency treatment(48 women in affected group died before childbirth, 24 cases were stillbirths, and 2 cases were unknown); 78 cases were missing in category of whether the newborn was specially treated in hospital (48 women in affected group died before childbirth, 24 cases were stillbirths, and 6 cases were unknown).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3368847&req=5

pone-0038467-g001: Non-funeral direct costs for households with maternal death.Note: costs presented here are sub-group analysis based on the affected group (n = 195); 48 cases were missing in category of delivery type (48 women in affected group died before childbirth and no delivery type was concerned); 74 cases were missing in category of whether the newborn received emergency treatment(48 women in affected group died before childbirth, 24 cases were stillbirths, and 2 cases were unknown); 78 cases were missing in category of whether the newborn was specially treated in hospital (48 women in affected group died before childbirth, 24 cases were stillbirths, and 6 cases were unknown).
Mentions: Direct costs were assessed as the household’s out-of-pocket expenditures associated with maternal death or childbirth (Table 2). The total direct costs with maternal death were more than ten times higher than those without maternal death (US$4,119 vs. $370, p<0.001). Funeral costs made up the largest category of the direct costs for the affected group (US$1,654). The non-funeral direct costs were quite substantial in affected group (US$2,464) and were more than six times higher than in comparison group (US$370)(p<0.001), reflecting the difference in hospitalization and emergency costs (US$2,248/case of maternal death versus US$305/case of childbirth without maternal death). Excluding 12 outliers (8 in affected group and 4 in unaffected group) higher than 3 SDs of mean, direct costs were still significantly higher in affected group compared with unaffected group (mean $3446 vs. $312, median $2452 vs. $224, p<0.001). We conducted multi-variable linear regression to control for possible confounders, including province, age of the mother, whether the mother was literate, whether the mother had pregnancy complications etc. The results showed that after controlling these characteristics, the non-funeral direct costs were still significantly higher in affected group, and the ratio between two groups increased slightly (3.32 vs. 3.46) (see Table S1). The non-funeral direct costs were principally for intensive care for the maternal and newborn, and referral expenses (Figure 1).

Bottom Line: The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001).The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

View Article: PubMed Central - PubMed

Affiliation: Division of Maternal and Child Health, School of Public Health, Peking University Beijing, Beijing, China.

ABSTRACT

Objective: To identify the immediate economic impact of maternal death on rural Chinese households.

Methods: Results are reported from a study that matched 195 households who had suffered a maternal death to 384 households that experienced a childbirth without maternal death in rural areas of three provinces in China, using quantitative questionnaire to compare differences of direct and indirect costs between two groups.

Findings: The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001). More than 40% of the direct costs were attributed to funeral expenses. Hospitalization and emergency care expenses were the largest proportion of non-funeral direct costs and were higher in households with maternal death than the comparison group (US$2,248 vs. $305, p<0.001). To cover most of the high direct costs, 44.1% of affected households utilized compensation from hospitals, and the rest affected households (55.9%) utilized borrowing money or taking loans as major source of money to offset direct costs. The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.

Conclusion: The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

Show MeSH
Related in: MedlinePlus