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Background: Achieving Universal Health Coverage according to The World Health Assembly’s way to reinforce the principle of human right to health in 2005 has been a huge task for India. India has one of the highest proportions of household out-of-pocket expenditures on health in the world, estimated at 71.1% in 2008–09. The unpredictable payments are impoverishing an estimated 3.3% of India's population every year. In this regard various strategies have been adopted such as—reforming tax based health financing or introducing health insurance. This highlights the need for alternative finances which includes the provision of medical insurance. The study was conducted to assess the out-of-pocket health expenditure and estimate the prevalence of protective mechanisms against it in an urban area- Bangalore.Methods: A longitudinal study was conducted in the urban area of Bangalore. Sample size was calculated to be 350 households. Data regarding socio-demographic profile, protective mechanisms and other details were obtained by interview method using a pre-tested and semi-structured questionnaire.Results: Majority were in the productive age group i.e. 991 (62.68%) individuals. Female population was slightly higher in our study. Most of the households belonged to upper lower class (54.29%). A major burden of health care cost was experienced both in acute as well as chronic illness by the households. Only 8.9% (31 households) had one or the other type of health insurance.Conclusions: Population has profound chances of experiencing catastrophic health expenditure in times of severe illness.
RESUMO
Introduction To date, there is a paucity of literature offering practicing urologists a reference for the amount of radiation exposure received while surgically managing urolithiasis. This study examines the cumulative radiation exposure of an urologist over 9 months. Materials and Methods We present a case series of fluoroscopic exposures of an experienced stone surgeon operating at an academic comprehensive stone center between April and December 2011. Radiation exposure measurements were determined by a thermoluminescent dosimeter worn on the outside of the surgeon's thyroid shield. Estimations of radiation exposure (mrem) per month were charted with fluoroscopy times, using scatter plots to estimate Spearman's rank correlation coefficients. Results The total 9-month radiation exposure was 87 mrems for deep dose equivalent (DDE), 293 mrem for lens dose equivalent (LDE), and 282 mrem for shallow dose equivalent (SDE). Total fluoroscopy time was 252.44 minutes for 64 ureteroscopies (URSs), 29 percutaneous nephrolithtomies (PNLs), 20 cystoscopies with ureteral stent placements, 9 shock wave lithotripsies (SWLs), 9 retrograde pyelograms (RPGs), 2 endoureterotomies, and 1 ureteral balloon dilation. Spearman's rank correlation coefficients examining the association between fluoroscopy time and radiation exposure were not significant for DDE (p = 0.6, Spearman's rho = 0.2), LDE (p = 0.6, Spearman's rho = 0.2), or SDE (p = 0.6, Spearman's rho = 0.2). Conclusions Over a 9-month period, total radiation exposures were well below annual accepted limits (DDE 5000 mrem, LDE 15,000 mrem and SDE 50,000 mrem). Although fluoroscopy time did not correlate with radiation exposure, future prospective studies can account for co-variates such as patient obesity and urologist distance from radiation source. .