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Objective To evaluate the illness-related expenditure by families of children with West syndrome (WS) during the first year of illness and to explore the potential determinants of the financial drain. Methods This cross-sectional study was conducted at a tertiary care hospital between July 2018 and June 2020. Eighty-five children with WS who presented within one year from the onset of epileptic spasms were included. The details of the treatment costs (direct medical and nonmedical) incurred during the first year from the onset of epileptic spasms were noted from a parental interview and case record review. Unit cost was fixed for drugs and specific services. Total cost was estimated by multiplying the unit cost by the number of times a drug or service was availed. The determinants of the financial burden were also explored. Results The median monthly per-capita income of the enrolled families (n = 85) was INR 3000 (Q1, Q3, 2000, 6000). The median cost of treatment over one year was INR 27035 (Q1, Q3, 17,894, 39,591). Median direct medical and nonmedical expenses amounted to INR 18802 (Q1, Q3, 12,179, 25,580) and INR 6550 (Q1, Q3, 3500, 15,000), respectively. Seven families had catastrophic healthcare expenditure. Parental education and choice of first-line treatment were important determinants driving healthcare expenses. The age at onset of epileptic spasms, etiology, treatment lag, the initial response to treatment, and relapse following initial response did not significantly influence the illness-related expenditure by the families. Conclusion WS imposes a substantial financial burden on the families and indirectly on the healthcare system.
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Objective To explore the hospitalization time and family financial burden of children under 14 years old with severe asthma in this region. Methods Children under 14 years old with severe asthma who were admitted to our hospital from January 2017 to December 2019 as a result of an acute attack were selected in this study. Questionnaire surveys, hospital charging system, and follow-up methods were used to collect clinical data, length of hospital stay, and direct and indirect costs of the children with asthma. Stepwise regression was applied to analyze the factors influencing the total cost. Results A total of 206 children were enrolled from 2017 to 2019, including 117 males and 89 females, with an average age of (7.24±1.53) years old. The total age distribution mainly consisted of six months to 3 years old (33.01%), >3 to 4 years old (24.27%), and >6-13 years old (20.39%). The onset season was mainly autumn and winter (33.01%). The average length of hospital stay was (8.50±1.42) d. The annual average family cost was (6884.20±957.61) RMB. The length of hospital stay decreased year by year, while the total cost increased year by year (P<0.05). Multiple stepwise regression analysis showed that the length of hospitalization, antibiotic use time, and presence/absence of allergic rhinitis, pulmonary heart disease and GINA standard treatment were the related factors affecting the total cost in children with severe asthma (P<0.05). Conclusion From 2017 to 2019, the hospitalization time of children under 14 years old with severe asthma in this region decreased over time, while the total cost gradually increased. Shortening the hospitalization time, actively preventing and controlling complications, and standardizing treatment can effectively reduce the financial burden of children's families.
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Background:Sickle cell disease is a genetic condition that affects millions of people globally. In view of this, the study aims at determining the financial burden of sickle cell disease among caregivers of children with sickle cell disease in Nigeria.Methods:It was a descriptive cross sectionalstudy and systematic sampling method was used in selecting 162 caregivers amongst the patients in the Lagos State University Teaching Hospital. Semi-structured questionnaires were used to collect data and analysed using SPSS version 22 software and Microsoft Excel 2007. Results were presented in frequency tables, chi-square to test association between categorical variables and the statistical significance level was set at p<0.05.Results:The mean age of the caregivers was 34.3 years with an increase in frequency of hospitalization 39% amongst respondents and a cost of hospital bill was over thirty thousand naira (US$76.82).The reason given mostly by 77% of the respondents for non-usage of health insurance was that the enrolment’s premium was high and 53% of the caregivers took loan to treat their wards. Catastrophic healthcare expenditure was found among a quarter 21% of the respondents due to non-usage of health insurance. There was a statistical significance association between level of education and Catastrophic healthcare expenditure at p value <0.05.Conclusions:Due to high level of financial burden on caregivers and family members, it will be an important step for the government to strengthen the health insurance scheme, intensify campaigns and subsidize costs of healthcare for these patients.
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El cáncer de mama es una de las enfermedades que causa más muertes de mujeres en el mundo. Hay barreras y situaciones que ponen en riesgo los mejores resultados para su control. Este estudio describirá la carga financiera que asumen estas mujeres y sus familias desde el enfoque de cuidado. Objetivo. Describir la carga financiera familiar asociada al cuidado de la mujer con cáncer de mama. Materiales y métodos. Estudio descriptivo cuantitativo de corte trasversal. Realizado con 71 mujeres de la Fundación SIMMON (Sinergias integradas para el mejoramiento del manejo oncológico). El estudio tiene el aval de la Facultad de Enfermería de la Universidad Nacional de Colombia. Los datos se obtuvieron con la Encuesta "Costo financiero del cuidado de la Enfermedad crónica". "La metodología Caracol" de Mayorga et al. Se usó para analizar los datos, comparándolos a partir de un diagrama. Resultados: La mayor fuente de CF fue transporte con un ángulo de 44,8°, salud con 27,8°, Vivienda con 25°, comunicaciones con 24,4° y por último alimentación con 24°. La mayor fuente de ingresos es su pensión o la de su pareja y el trabajo formal e informal. La mayor fuente de endeudamiento son los préstamos bancarios con 38%. La calificación del nivel de preocupación que genera la CF fue 4 el nivel más alto con 63,3%. Conclusiones: Las mujeres con cáncer de mama tienen una alta CF asociada al cuidado y hacen falta políticas públicas y estrategias sostenibles para mitigarla.
The breast cancer is one of the diseases that cause more deaths of women in the world. There are barriers and situations that put at risk the best results for their control. This study will describe the financial burden that these women and their families assume form the care approach. Objective. Describe the family financial burden associated with caring for women with breast cancer. Materials and methods. Descriptive quantitative study of cross section. Made with 71 women linked to the SIMMON foundation (Integrated synergies for the improvement of oncological management). The study has the endorsement of the Faculty of Nursing of the National University of Colombia. The data was obtained with the Survey "Financial cost of chronic disease care". The Caracol methodology of Mayorga et al. It was used to analyze the data by comparing them from a diagram. Results. The main source of CF was transport with an angle of 44.8°, health with 27.8°, housing with 25°, communications with 24.2° and finally with 24° feeding. The main source of income is your presion or that of your partner and formal and informal work. The biggest source of indebtedness in bank loans with 38%. The level of concern generated by the CF was 4 the highest level with 63.3%. Conclusions. Women with breast cancer have a high CF associated with their care since the diagnosis and public policies and sustainable strategies are needed to mitigate it.
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Humans , Female , Breast Neoplasms , Cost of Illness , Caregivers , Financial StressABSTRACT
Medical economic burden, also known as economic burden caused by disease, is defined as the actual or potential resources consumed for health needs. Research on the medical economic burden in China starts late and has a weak foundation compared with European and American countries, but it has developed rapidly in recent years. At present, there is no uniform standard on the academic definition, content and classification of medical economic burden. Moreover, most researchers in China mainly focus on the economic burden of single disease, with abundant contents but limited and traditional methods, and the researches on the factors influencing the medical economic burden and the medical economic burden caused by medical insurance and health investment are rare. In this paper, we proposed that the future research directions of medical economic burden may include the following aspects: (1) empirical and exploratory studies on the influencing factors of medical and health service costs; (2) to introduce catastrophic medical indexes, explore innovative measurement methods for medical economic burden, and compare the differences between different measurement methods; and (3) exploratory research on medical economic burden through interdisciplinary perspectives.
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INTRODUCTION: This project was started after patient’s complaints of increased cost burden on patients with increase stay of patient in hospital for chemotherapy administration for 3–4 days, how to decrease this hospital stay and financial burden and how can we improve services to decrease hospital stay and expedite the process of chemotherapy administration. METHODS: A total of 100 patients’ confidential files reviewed from February 12, 2013 to May 15, 2013, patients, who were admitted for chemotherapy administration only in inpatient area and all services timings, were reviewed and documented on sheet named as delays chemotherapy sheet, nine processes timings checked against their benchmarks. RESULTS: All services process timings analyzed and compared with their benchmarks, results of all services timings are nearly close to benchmark except lab test results of patients who were admitted without labs test for chemotherapy administration delays seen in collecting blood sample and sending this sample to the laboratory, significant delay is seen in chemotherapy order entry by physician if patient is admitted after 4 p.m. for chemotherapy administration. Delays also identified in administration of chemotherapy. CONCLUSION: After identifying the reasons of delays in chemotherapy administration, improvement and innovation in chemotherapy administration process done which not only decrease hospital stay, but also decrease the cost of chemotherapy administration.
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Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.
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Based on analysis of researches in China and abroad on financial burden of hospital acquired infection,the paper named key setbacks in such a study in China and advocated prospective studies in this regard.Furthermore,the authors proposed studies on the financial burden incurred by years of life lost due to such infection,and that on the burden from the hospital perspectives.On the basis of direct and indirect financial burdens,the assessment and dynamic analysis of overall financial burden were proposed,to establish a uniform evaluation method or guidance for such infection and ensure the compatibility of various research outcomes.
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Objective To investigate and analyze the health care seeking behavior,financial burden and relative factors of patients with rheumatic diseases in Fujian Province.Methods Patients diagnosed with rheumatic diseases were investigated in Fujian Provincial Hospital from December 2013 to February 2014,including demographic data,health care seeking behavior and financial burden.Relevant factors were analyzed by Logistic regression.Results ① In this study,474 patients were enrolled.The ratio of male to female was 1∶2.38.② At the onset of symptoms,51.9％(246 cases) of patients visited a doctor as soon as possible,and 36.1％(171 cases) of them went to hospital within a month after disease onset.③ 74.1％(351 cases) of patients could adhere to medication regimen prescribed by doctors,and the most common reason for stopping medication was symptoms relieved (33.3％,41 cases).④ 63.1％(299 cases) of patients learned about the knowledge of rheumatic diseases from hospitals and doctors.⑤ 34.2％(162 cases) of patients spent 1 000-5 000 yuan every month on treatment.⑥ Insurance type could affect the time of first visit to hospital (P=0.004),while income and cost of therapy might impact patients' compliance (P=0.013,P=0.004).Conclusion Most patients will go to hospital as soon as possible and adhere to treatment.Economic situation is the main factor influencing health care seeking behavior of patients with rheumatic diseases.
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Chronic diseases have a serious impact on individuals and on society in general. They affect the quality of life of individuals and can be a financial burden on those who are affected. There is a disease continuum of lifestyle, high risk diseases, and end organ damage. Lifestyle change is necessary if we are to reduce the prevalence of these chronic diseases. The Health Choices, Lifestyle Advice Resource for Healthcare Professionals provides a tool for lifestyle counselling.
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Objective. To assess the social and financial burden on parents of children with locomotor disability. Methods. A cross-sectional study was conducted in the Institute for Physically Handicapped (IPH), Delhi, where parents of 100 locomotor disabled children of age group 6 to 15 years were interviewed to estimate the socioeconomic burden of caregiving their children. Results. The study observed that the parents of the disabled children were severely burdened in terms of financial burden and mental health. Conclusions. There is an urgent need for support activities for such families at a national level in order to curb the huge economic and social burden of care-giving. Counselling should be an integral part of rehabilitat ion for such families.
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Activities of Daily Living , Adolescent , Chi-Square Distribution , Child , Cost of Illness , Counseling , Cross-Sectional Studies , Disabled Children/psychology , Family Health , Female , Humans , India , Interviews as Topic , Male , Parent-Child Relations , Parents/psychology , Socioeconomic FactorsABSTRACT
Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.
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The purpose of this study was to investigate a plan of middle/high school foodservice systems which could properly provide nutrition for juveniles' health. Questionnaires were developed and distributed to: 245 middle schools with 271 parentis, 328 students, 180 teachers, and 345 administrators; 163 high-schools with 223 parents, 466 students, 179 teachers, and 163 administrators in Seoul and Kyunggi province. The results of this study were as followed. For the desirable feeding type as in-school meal plan, 62.2% responded to the current elementary school feeing type;10.3% responded to a lunch-box prepared at home; and 38.0% responded to free dining out type. For a feeding operation type, school administrators, teachers and parents favored the current school feeding systems in elementary schools with proportion of 68.2%, 47.7%, and 87.6% as respectively. Also, 20.3% of school administrators, 22.6% of teachers, and 6.9% of parents preferred contract management. A total of 27.6% of teachers, 9.2% of school administrators, and 3.7% of parents responded to a lunch-box prepared at home. There was a significant difference between the responses for establishing the main body of financial burden to solve the problem of financial burden which could be the most obstacle to bring middle/high school feeding system into operation. For the management of school feeding systems when brought into operation, 88.7% out of 470 responded schools and 89.9% out of 227 responded teachers reported that an expert should manage school feeding systems. For futuristic direction, an effective joint cooking type between schools which may be the way to solve the difficulties in securing the appropriate space and to decrease the financial burden, the problem of transportation for delivering feeding products, low quality of feeding, and sanitation can occur. Therefore, the distance between schools which operate a joint cooking system will affect as a major factor. Furthermore, concrete examination of plans for introduction of various types of school feeding and institutional devices for management system and supervision of operation should become a condition precedent.
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Humans , Administrative Personnel , Cooking , Fees and Charges , Joints , Meals , Organization and Administration , Parents , Surveys and Questionnaires , Sanitation , Seoul , TransportationABSTRACT
Objective To study the effect of different intervenient measures for TB control on disease financial burden. Method A survey was conducted of the expenses incurred on 1 700 new and retreated TB patients from areas covered by the World Bank project, the Ministry of Public Health project, and non project areas where intervenient measures were also taken. The method of economic estimation was used to explore the disease financial burden carried by the patients families and society. Result The average family disease financial burden is as follows: 1 735 yuan for a new case and 2 755.99 yuan for a retreated case in the international TB program(ITP); 2 669.27 yuan for a new case and 3 530.17 yuan for a retreated case in the national TB program(NTP); and 6 787.02 yuan for a new case and 7 276.10 yuan for a retreated case in the non project areas using conventional TB therapy(CTT). The average social disease financial burden is as follows: 4 735.55 yuan in ITP; 6 471.91 yuan in NTP; and 10 919.96 yuan in CTT. Conclusion The disease financial burden was the lowest in ITP, highest in CTT, and intermediate in NTP.