Table 6.
Logistic regression model of the relationship between risk factors and catastrophic cost (cost burden ≥ 1%) for one pediatric diarrheal episode, in a sample of 551 Bolivian children seeking care for acute diarrhea, 2007 - 2009
|
Variable |
|
Unadjusted analysis |
Adjusted model 1 (n = 295) |
Adjusted model 2 (n = 295)* |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N | OR | 95% CI | P | OR | 95% CI | P | OR | 95% CI | P | |
|
Demographics |
|
|
|
|
|
|
|
|
|
|
| Male child |
550 |
1.49† |
(1.06, 2.10) |
0.02 |
1.04 |
(0.59, 1.86) |
0.89 |
1.00 |
(0.55, 1.81) |
1.00 |
| Age of child (months) |
524 |
0.98 |
(0.96, 1.00) |
0.07 |
0.99 |
(0.96, 1.02) |
0.53 |
1.00 |
(0.96, 1.03) |
0.77 |
| Number of people in household |
524 |
1.02 |
(0.95, 1.09) |
0.60 |
1.00 |
(0.88, 1.13) |
0.95 |
0.96 |
(0.84, 1.09) |
0.51 |
| Rural residence |
458 |
1.76† |
(1.09, 2.86) |
0.02 |
1.54 |
(0.73, 3.26) |
0.26 |
1.33 |
(0.62, 2.86) |
0.47 |
| Hospital |
536 |
|
|
|
|
|
|
|
|
|
| Albina Patiño (Private) |
|
3.39† |
(2.36, 4.89) |
<0.01 |
4.13† |
(2.30, 7.41) |
<0.01 |
5.26† |
(2.86, 9.68) |
<0.01 |
| All Others (Public, Reference) |
|
1.00 |
- |
- |
1.00 |
- |
- |
1.00 |
- |
- |
|
Treatment-Seeking Behavior |
|
|
|
|
|
|
|
|
|
|
| Sought treatment at least once previously to current visit |
467 |
8.05† |
(3.92,16.55) |
<0.01 |
3.92† |
(1.64, 9.35) |
<0.01 |
4.84† |
(1.83,12.75) |
<0.01 |
| Number of transportations taken to current visit |
428 |
1.18 |
(0.80, 1.75) |
0.41 |
1.28 |
(0.70, 2.33) |
0.42 |
1.79 |
(0.97, 3.30) |
0.06 |
| Number of days child had diarrhea prior to current visit |
513 |
1.02 |
(1.00, 1.05) |
0.10 |
1.14† |
(1.05, 1.24) |
<0.01 |
1.09† |
(1.02, 1.16) |
0.01 |
|
Severity of illness |
|
|
|
|
|
|
|
|
|
|
| Child was an outpatient |
551 |
0.35† |
(0.25, 0.49) |
<0.01 |
0.16† |
(0.07, 0.37) |
<0.01 |
0.10† |
(0.04, 0.24) |
<0.01 |
| Child presented with at least one complication‡ |
548 |
2.10† |
(1.49, 2.96) |
<0.01 |
1.38 |
(0.57, 3.34) |
0.47 |
0.42† |
(0.19, 0.93) |
0.03 |
| Child’s first episode of diarrhea |
466 |
1.1 |
(0.75, 1.60) |
0.64 |
1.47 |
(0.79, 2.75) |
0.22 |
1.60 |
(0.83, 3.06) |
0.16 |
|
Interaction term |
|
|
|
|
|
|
|
|
|
|
| Number of days with diarrhea (1-unit change) × at least one complication | - | - | - | - | 1.37† | (0.59, 3.2) | 0.03 § | - | - | - |
*Second adjusted model excludes direct non-medical costs of diapers and extra food. †P < 0.05. ‡Complications were defined as at least one of the following, as diagnosed by the attending physician: electrolyte disorder, electrolyte imbalance, hypokalemia, metabolic acidosis, anemia, malnutrition, acute respiratory infection, bronchopneumonia, intussusception, dehydration, or any other unnamed complication. §P-value associated with the overall interaction coefficient. Italicized text indicates p < 0.05.