scholarly journals The Financial Burden of Catastrophic Health Expenditure on Households with Chronic Diseases: Financial Ratio Analysis

2021 ◽  
Author(s):  
Hyunwoo Jung ◽  
Young Dae Kwon ◽  
Jin-Won Noh
Keyword(s):  
Chronic Disease ◽  
Health Expenditure ◽  
Financial Burden ◽  
Catastrophic Health Expenditure ◽  
Financial Strain ◽  
Income Loss ◽  
Absolute Size ◽  
Financial Ratio ◽  
Financial Ratio Analysis ◽  
Indicator Liquid

Abstract Background: The financial status of households is vulnerable to chronic disease related to high medical expenses and income loss; The financial strain could be assessed by the five indicators. household surplus indicator, liquid asset/debt ratio, solvency indicator, and liquidity indicator.Purpose: We investigated the association between catastrophic health expenditure (CHE) and financial ratio indicators in households with chronic disease in South Korea. Methodology: To determine the financial strain, thresholds were applied to the financial ratios. We conducted multiple logistic regression to figure out whether CHE is associated with financial strain. Furthermore, we analyzed the effect of CHE on absolute finance size, which is basic financial indicators, by multiple linear regression.Results: When CHE occurred, all of the financial ratio indicators deteriorated. However, it was not due to decreases in the absolute size of wealth, income, but rather the relative balance between finances. Especially, the loss of the liquid assets was the major factor of deterioration. Also, all types of labor-related income deteriorated. Only the private transfer income increased.Conclusion: This study revealed that CHE in households with chronic disease negatively impacts the household's finances. It turned out that the financial coping strategies are only resource-consuming.

scholarly journals Meta-Analysis the Effect of Chronic Disease on Catastrophic Health Expenditure

2020 ◽  
Author(s):  
Yeny Ristaning Belawati ◽  
◽  
Didik Gunawan Tamtomo ◽  
Bhisma Murti ◽  
◽  
...  
Keyword(s):  
Chronic Disease ◽  
Odds Ratio ◽  
Health Expenditure ◽  
English Language ◽  
Adjusted Odds Ratio ◽  
Financial Burden ◽  
Meta Analysis ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Cross Sectional

ABSTRACT Background: The growing prevalence of chronic diseases contributed to high financial risks of health care. High total out-of-pocket health expenditure relative to income can result in catastrophic health expenditure. This meta-analysis was performed to assess the effect of chronic disease on catastrophic health expenditure. Subjects and Method: Meta-analysis and systematic review was conducted by collecting articles from Google Scholar, PubMed, Springer Link databases, which published from year 2000 to 2020. Keywords to collect the articles including,” chronic disease” OR “chronic illness” AND “catastrophic health expenditure” OR “financial burden” AND “cross sectional” AND “adjusted odds ratio”. The inclusion criteria were full text, in English language, using cross-sectional study design, and reporting adjusted odds ratio. Catastrophic health expenditure criteria if capacity to pay was ≥40% (excluding primary needs). The study population was households. The intervention was chronic disease with comparison non chronic disease. The study outcome was catastrophic health expenditure. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using Revman 5.3. Results: 9 studies from Tanzania, Korea, China, Ghana, and India were selected for this study. This study showed that chronic disease increased catastrophic health expenditure (aOR= 1.94; 95% CI= 1.45 to 2.54; p<0.001). Conclusion: Chronic disease increases catastrophic health expenditure. Keywords: chronic disease, catastrophic health expenditure Correspondence: Yeny Ristaning Belawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57216, Central Java. Email: [email protected]. Mobile: 082243302740. DOI: https://doi.org/10.26911/the7thicph.04.49

scholarly journals Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041870
Author(s):  
Tiara Marthias ◽  
Kanya Anindya ◽  
Nawi Ng ◽  
Barbara McPake ◽  
Rifat Atun ◽  
...  
Keyword(s):  
Panel Data ◽  
Health Service ◽  
Low Income ◽  
Health Expenditure ◽  
Service Use ◽  
Financial Burden ◽  
Panel Data Analysis ◽  
Productivity Loss ◽  
Catastrophic Health Expenditure ◽  
Health Service Use

ObjectivesTo examine non-communicable diseases (NCDs) multimorbidity level and its relation to households’ socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.DesignThis study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).SettingThe original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.ParticipantsWe included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents.Primary outcome measuresWe examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables,ResultsWomen were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95% CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95% CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95% CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95% CI 0.16 to 0.33) compared with no NCD.ConclusionsNCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries.

scholarly journals The catastrophic out-of-pocket health expenditure of multiple sclerosis patients in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Farid Gharibi ◽  
Ali Imani ◽  
Koustuv Dalal
Keyword(s):  
Multiple Sclerosis ◽  
Health Expenditure ◽  
Financial Burden ◽  
Occupational Status ◽  
Catastrophic Health Expenditure ◽  
Cross Sectional ◽  
Rehabilitation Care ◽  
Physician Visits ◽  
Out Of Pocket Payments ◽  
Multiple Sclerosis Patients

Abstract Background The present study was designed and conducted to evaluate multiple sclerosis (MS) treatment costs and the resulting economic impact imposed on MS patients in Iran. Methods This was a cross-sectional study, among randomly selected 300 MS patients, registered in the MS Association of East Azerbaijan Province, Iran (1 year after their treatment began). The regression analysis, ANOVA, T-test, and chi-square were used. Results The average amount of out-of-pocket payments (OOPs) by MS patients during the previous year was 1669.20 USD, most of which was spent on medication, rehabilitation care, and physician visits. Their mean annual income was 5182.84 USD. Fifty four percent of families with an MS patient suffer from catastrophic health expenditure (CHE) and 44% experience poverty caused by the OOPs. Occupational status, having supplemental health insurance, and being residents of Tabriz significantly affect OOPs, CHE, and the resulting poverty (P < 0.05). Conclusion The catastrophic financial burden of health care costs on MS patients and their families justifies health policymakers to promote pre-payment systems and provide subsidies to less well-off patients to protect them from the unfairness of OOPs and its resulting CHE and poverty.

scholarly journals Association of socioeconomic status with financial burden of disease among elderly patients with cardiovascular disease: evidence from the China Health and Retirement Longitudinal Survey

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018703 ◽  
Author(s):  
Chunyan Li ◽  
Belinda-Rose Young ◽  
Weiyan Jian
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Health Expenditure ◽  
Financial Risk ◽  
Financial Burden ◽  
Catastrophic Health Expenditure ◽  
Longitudinal Survey ◽  
Household Expenditure ◽  
Multilevel Regression ◽  
Financial Risk Protection

ObjectivesThe prevalence of cardiovascular diseases (CVD) within low-income and middle-income countries has reached epidemic proportions. However, the association between out-of-pocket (OOP) payment and socioeconomic status (SES) of patients with CVD is not well studied. We aimed to understand the financial burden among Chinese middle-aged and older patients with CVD, and whether there was an association with SES.SettingsA nationally representative survey—The China Health and Retirement Longitudinal Survey(CHARLS)—was conducted in 28 provinces of mainland China in 2011 and 2013.ParticipantsOf the over 18 000 CHARLS respondents, eligible participants were those aged 45 years and over who had been previously diagnosed with CVD.Outcome measuresFinancial burden was measured byindividualOOP payment andhouseholdcatastrophic health expenditure (CHE) occurrence (ie, the annual household health expenditure was 40% or more of the total non-food household expenditure). Multilevel regression models were used to explore the association between financial burden and SES.ResultsAmong CHARLS respondents, CVD prevalence increased from 14.7% in 2011 to 16.6% in 2013. Average annual CVD OOP payment increased from 5000 RMB (770 USD) to 6120 RMB (970 USD). Furthermore, CHE occurrence increased from 44.2% to 48.1%. Patients spent almost twice on outpatient as on inpatient services. Two of the three SES indicators (total household expenditure, occupation type) were found to be associated with CVD OOP payment amount, and the likelihood of CHE. Unemployed patients had a higher likelihood of CHE compared with agricultural workers. Rural-urban difference was associated with the likelihood of CHE in 2011 alone.ConclusionThe Chinese health system should use this health expenditure pattern among patients with CVD to create more equitable health insurance schemes that financially balance between outpatient and inpatient care, and provide better financial risk protection to patients with low SES.

scholarly journals The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shaoguo Zhai ◽  
Shuiping Yuan ◽  
Quanfang Dong
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Health Expenditure ◽  
Financial Burden ◽  
Catastrophic Health Expenditure ◽  
Western China ◽  
Cooperative Medical Scheme ◽  
The Impact ◽  
The Relationship ◽  
Rural Older Adults

Abstract Background Older adults are more prone to various diseases. Health insurance becomes effective mechanism to relieve financial burden when the insured is sick. In China, most older adults live in the countryside, and New Rural Cooperative Medical Scheme is a kind of health insurance system in rural areas. The relationship between New Rural Cooperative Medical Scheme and financial burden due to health expenditure of older adults in China was investigated. This paper aims at the impact of New Rural Cooperative Medical Scheme on the poverty among rural older adults. Methods This study employs Probit model and Tobit model to assess the impact of New Rural Cooperative Medical Scheme on alleviating poverty among rural older adults based on a survey in nine representative counties in western China. Results The findings show that diseases have significantly negative impact on rural elderly poverty. New Rural Cooperative Medical Scheme has impact on alleviating of the health-payment poverty due to catastrophic health expenditure, but the impact is limited. The impact of health insurance on poverty alleviation is greater for men, older adults aged between 60 to 69 and households in in economically poorer area than their counterparts. Conclusions This study show the relationship between New Rural Cooperative Medical Scheme and catastrophic health expenditure of older adults in China. The results draw policy attention to introduce different reimbursement expense ratios for different groups to alleviate them from poverty based on more comprehensive insurance packages.

scholarly journals Association between chronic disease and catastrophic health expenditure in Korea

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Jae-Woo Choi ◽  
Jong-Won Choi ◽  
Jae-Hyun Kim ◽  
Ki-Bong Yoo ◽  
Eun-Cheol Park
Keyword(s):  
Chronic Disease ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure

scholarly journals Decomposition of changes in socioeconomic inequalities in catastrophic health expenditure in Kenya

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244428
Author(s):  
Purity Njagi ◽  
Jelena Arsenijevic ◽  
Wim Groot
Keyword(s):  
Health Expenditure ◽  
Financial Burden ◽  
Household Wealth ◽  
Catastrophic Health Expenditure ◽  
Socioeconomic Inequalities ◽  
Financial Risk Protection ◽  
Wealth Status ◽  
The Poor ◽  
Household Heads ◽  
Over Time

Background Catastrophic health expenditure (CHE) is frequently used as an indicator of financial protection. CHE exists when health expenditure exceeds a certain threshold of household consumption. Although CHE is reported to have declined in Kenya, it is still unacceptably high and disproportionately affects the poor. This study examines the socioeconomic factors that contribute to inequalities in CHE as well as the change in these inequalities over time in Kenya. Methods We used data from the Kenya household health expenditure and utilisation (KHHEUS) surveys in 2007 and 2013. The concertation index was used to measure the socioeconomic inequalities in CHE. Using the Wagstaff (2003) approach, we decomposed the concentration index of CHE to assess the relative contribution of its determinants. We applied Oaxaca-type decomposition to assess the change in CHE inequalities over time and the factors that explain it. Results The findings show that while there was a decline in the incidence of CHE, inequalities in CHE increased from -0.271 to -0.376 and was disproportionately concentrated amongst the less well-off. Higher wealth quintiles and employed household heads positively contributed to the inequalities in CHE, suggesting that they disadvantaged the poor. The rise in CHE inequalities overtime was explained mainly by the changes in the elasticities of the household wealth status. Conclusion Inequalities in CHE are persistent in Kenya and are largely driven by the socioeconomic status of the households. This implies that the existing financial risk protection mechanisms have not been sufficient in cushioning the most vulnerable from the financial burden of healthcare payments. Understanding the factors that sustain inequalities in CHE is, therefore, paramount in shaping pro-poor interventions that not only protect the poor from financial hardship but also reduce overall socioeconomic inequalities. This underscores the fundamental need for a multi-sectoral approach to broadly address existing socioeconomic inequalities.

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