scholarly journals The affordability of prescription medicines in Australia: are copayments and safety net thresholds too high?

2013 ◽  
Vol 37 (1) ◽  
pp. 32 ◽  
Author(s):  
Andrew Searles ◽  
Evan Doran ◽  
Thomas A Faunce ◽  
David Henry
Keyword(s):  
Financial Burden ◽  
Monitoring And Evaluation ◽  
Access To Medicines ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Prescription Medicines ◽  
Main Determinants ◽  
The Cost

Objective. To create and report survey-based indicators of the affordability of prescription medicines for patients in Australia. Method. A cross-sectional study of 1502 randomly selected participants in the Hunter Region of NSW, were interviewed by telephone. Main outcome measure. The self-reported financial burden of obtaining prescription medicines. Results. Data collection was completed with a response rate of 59.0%. Participants who had received and filled at least one prescription medicine in the previous 3 months, and eligible for analysis (n=952), were asked to self-report the level of financial burden from obtaining these medicines. Extreme and heavy financial burdens were reported by 2.1% and 6.8% of participants, respectively. A moderate level of burden was experienced by a further 19.5%. Low burden was recorded for participants who said that their prescription medicines presented either a slight burden (29.0%) or were no burden at all (42.6%). Conclusion. A substantial minority of participants who had obtained prescription medicines in the 3 months prior to survey experienced a level of financial burden from the cost of these medicines that was reported as being moderate to extreme. What is known about the topic? The Australian National Medicines Policy aims to, amongst other things, facilitate access to medicines at a cost that is affordable to individuals and the community. Copayments combined with the safety net and brand price premium are the main determinants of the amount that patients pay for PBS listed prescription medicines. Previous surveys have reported on selected aspects of medicine affordability in Australia and have shown some groups in the population experience difficulty with the cost of their medicines. What does this paper add? This paper develops and reports on a set of indicators that can be used to periodically measure the level of self-reported financial burden experienced by Australians when obtaining prescription medicines. The analysis assesses affordability issues for both general patients and patients who are able to access prescription medicines using a concession card. What are the implications? Our research suggests that, as they stand, the copayment and safety net thresholds are not protecting nearly one-third of Australian patients from financial burden. Ongoing monitoring and evaluation is required to ensure the copayment and safety net thresholds do not jeopardise the National Medicines Policy’s principle of equitable and affordable access to medicines.

scholarly journals The Cost of Living with Inherited Ataxia in Ireland

2021 ◽  
Author(s):  
Mark J. Kelly ◽  
Petya Bogdanova-Mihaylova ◽  
Joshua Skeens ◽  
Sharon Moran ◽  
Sorcha Farrelly ◽  
...  
Keyword(s):  
Cost Of Illness ◽  
Financial Burden ◽  
Indirect Costs ◽  
Cross Sectional Study ◽  
Standards Of Care ◽  
Resource Utilisation ◽  
Cross Sectional ◽  
Healthcare Resource Utilisation ◽  
Health And Social Care ◽  
The Cost

AbstractInherited ataxias are a heterogenous group of neurodegenerative disorders characterised by progressive impairment of balance and coordination, typically leading to permanent and progressive disability. Diagnosis and management of these disorders incurs a range of direct and indirect financial costs. The aim of this study was to collect individual ataxia-related healthcare resources in a large cohort of individuals with different subtypes of inherited ataxia and calculate the associated cost of illness in the Republic of Ireland. One hundred twenty-nine respondents completed a cross-sectional study on healthcare resource utilisation for progressive ataxia in Ireland. Costs were calculated using a prevalence-based approach and bottom-up methodology. The COI for inherited ataxia in 2016 was €59,993 per person per year. Results were similar between participants with Friedreich’s ataxia (FRDA, n = 56), non-FRDA (n = 18) and those with undetermined ataxia (n = 55). Indirect costs, based on productivity losses by participants or caregivers, accounted for 52% of the cost of illness. Inherited ataxia is associated with significant health and social care costs. Further funding for inherited ataxia to ease the financial burden on patients, caregivers and healthcare system and improve standards of care compliance is warranted.

Depression and polypharmacy are risk factors for activity limitation in type 2 diabetes

2020 ◽  
pp. 174239532095943
Author(s):  
Tara C Klinedinst ◽  
Tracy L Nelson ◽  
Gene W Gloeckner ◽  
Matt P Malcolm
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Functional Decline ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Age Related

Objectives Individuals with type 2 diabetes are at risk for deficits in instrumental activities of daily living (IADL: e.g., managing medication, preparing healthy meals). Understanding which demographic and health factors contribute to decreased frequency of IADL performance is especially important to prevent age-related functional decline in type 2 diabetes. This study examined the relationships among demographic and health variables and frequency of IADL performance in adults with type 2 diabetes. Methods For this cross-sectional study, we collected health, demographic, and activity information via self-report and electronic health record review from safety-net primary care patients with type 2 diabetes (n = 93). We used regression models to determine which factors were associated with IADL performance in three subscales (domestic, leisure/work, outdoor) and the overall score. Results Depression was associated with decreased frequency of IADL performance for domestic, leisure/work, and outdoor activities. Each additional daily medication was associated with decreased frequency of domestic and outdoor IADL performance. Discussion Depression and taking more daily medication were predictors of decreased IADL performance for adults with type 2 diabetes. Our findings suggest regular screening for depression and polypharmacy is important in the primary care of diabetes; especially as these are potentially modifiable risk factors.

scholarly journals Stress and Financial Burden Faced by Dentists Amidst COVID 19 Pandemic

2021 ◽  
pp. 303-310
Author(s):  
Amruta Popatrao Patil ◽  
Dilip Magdum ◽  
Santosh Jadhav ◽  
Abhijeet Jadhav ◽  
Prakash Vhatkar ◽  
...  
Keyword(s):  
Patient Flow ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Dental Procedures ◽  
Media Platform ◽  
Socio Economic Impact ◽  
Saliva Contamination ◽  
The Cost

Introduction: The Covid-19 pandemic, initiated in Wuhan, China, had devastating effects on the dental industry world-wide. The mode of transmission of SARS Cov-2, causative agent of Covid-19, was through aerosol and saliva contamination putting dentists at high risk of contracting Covid-19. The measures taken to contain the spread of virus had financial repercussion on the dental industry. The survey was conducted to understand the mental health of dentists amidst Covid-19 pandemic. Aim: To analyse the concerns and anxiety faced by dental surgeons regarding vaccination and the psychological and socio-economic impact Covid-19 pandemic had on dental setups. Methods: A cross-sectional study was conducted for a period of 3 months. A sample size of 300 dentists belonging to age group of 25years to 45years was analysed. The dentists included in the sample practiced in Maharashtra, India. A questionnaire was formulated in Google forms and circulated through social media platform. The result was analysed and demonstrated in pie-charts. Results: The survey analysed that majority of dentists were apprehensive to carry out dental procedures. Along with the risk of contracting and being a source of transmission of Covid-19, dentists had huge financial burden of clinic rents, EMI loan pending bills, the cost of preventive kits and reduced patient flow. Conclusion: The survey was successful in analysing the monetary and safety concerns faced by dentists amidst Covid-19 pandemic. The survey also pointed out the mental stress dentists had to overcome to practice dental procedures.

Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe
Keyword(s):  
Depressive Symptoms ◽  
Undergraduate Students ◽  
Cross Sectional Study ◽  
Self Report ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Blame ◽  
Self Harm ◽  
The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

Does Dispositional Mindfulness Predict the Development of Grit?

2018 ◽  
Vol 39 (2) ◽  
pp. 76-87 ◽  
Author(s):  
Buaphrao Raphiphatthana ◽  
Paul Jose ◽  
Karen Salmon
Keyword(s):  
Undergraduate Students ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Self Report ◽  
Dispositional Mindfulness ◽  
Cross Sectional ◽  
Report Data ◽  
Self Report Data ◽  
Acting With Awareness ◽  
Mindfulness Facets

Abstract. Grit, that is, perseverance and passion for long-term goals, is a novel construct that has gained attention in recent years ( Duckworth, Peterson, Matthews, & Kelly, 2007 ). To date, little research has been performed with the goal of identifying the antecedents of grit. Thus, in order to fill this gap in the literature, self-report data were collected to examine whether mindfulness, a mindset of being-in-the-present in a nonjudgmental way, plays a role in fostering grittiness. Three hundred and forty-three undergraduate students completed an online survey once in a cross-sectional study, and of these, 74 students completed the survey again 4.5 months later. Although the cross-sectional analyses identified a number of positive associations between mindfulness and grit, the longitudinal analysis revealed that the mindfulness facets of acting with awareness and non-judging were the most important positive predictors of grit 4.5 months later. This set of findings offers implications for future grit interventions.

Individual differences related to present and future mental orientation predict the sense of time

2017 ◽  
Author(s):  
Marc Wittmann ◽  
Henrike Fiedler ◽  
Wilhelm Gros ◽  
Julia Mossbridge ◽  
Cintia Retz Lucci
Keyword(s):  
Individual Differences ◽  
Time Perspective ◽  
Cross Sectional Study ◽  
Self Report ◽  
Reproduction Task ◽  
Cross Sectional ◽  
Waiting Period ◽  
Frequency Scale ◽  
Temporal Intervals ◽  
Sense Of Time

With this cross-sectional study we investigated how individual differences regarding present- and future-oriented mental processes are related to the experience of time in the seconds and minutes range. A sample of students (N = 100) filled out self-report measures of time perspective (ZTPI), mindfulness (FMI), impulsiveness (BIS), and the daydreaming frequency scale (DDFS). Furthermore they were asked to (a) retrospectively judge the duration of a waiting period of five minutes, and (b) to prospectively perform an visual duration reproduction task with intervals of 3, 6, and 9 seconds. Regression models show that (a) being more present fatalistic (ZTPI) and more impulsive are related to longer duration estimates of the waiting period, and (b) having a stronger propensity to daydream leads to a stronger under-reproduction of temporal intervals. These findings show how personality traits related to present orientation are associated with the state-like perception of duration.

scholarly journals Prevalence of disabilities and non-communicable diseases in an elderly population in the Telangana state, India: a population-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe
Keyword(s):  
Elderly Population ◽  
Self Care ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Self Report ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

scholarly journals Mental health and its association with coping strategies and intolerance of uncertainty during the COVID-19 pandemic among the general population in Saudi Arabia: cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmad N. AlHadi ◽  
Mohammed A. Alarabi ◽  
Khulood M. AlMansoor
Keyword(s):  
Mental Health ◽  
Saudi Arabia ◽  
Coping Strategies ◽  
Intolerance Of Uncertainty ◽  
Cross Sectional Study ◽  
Self Report ◽  
Sectional Study ◽  
Mental Health Symptoms ◽  
Cross Sectional ◽  
Health Symptoms

Abstract Background The COVID-19 pandemic has had a major impact on people’s lives globally. The outbreak in Saudi Arabia worsened when the number of cases and deaths rose in March and April of 2020, leading to a national lockdown. This study aimed to assess the factors associated with mental health symptoms in a sample of people residing in Saudi Arabia during the COVID-19 pandemic. Methods We conducted an observational cross-sectional study using an online survey distributed via social media, completed by 3032 respondents from all Saudi regions. We collected demographic data, illness history, and scores of validated self-report scales to assess mental health symptoms, intolerance of uncertainty, and coping strategies. Results In total, respondents indicated moderate to very severe symptoms during the pandemic as follows: 20.9% for depression, 17.5% for anxiety, and 12.6% for stress. Younger age, female gender, and history of mental illness were associated with higher levels of depression, anxiety, stress, and insomnia. Intolerance of uncertainty and certain coping strategies (such as denial or self-blame) were associated with more severe symptoms. Conclusions Mental health is a key concern during the COVID-19 pandemic, especially for the identified vulnerable groups. Agencies concerned with mental health during crises may use the studied associated factors of mental health symptoms to generate targeted policies or interventions.

scholarly journals Processes of care and outcomes for homeless patients hospitalised for cardiovascular conditions at safety-net versus non-safety-net hospitals: cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046959
Author(s):  
Atsushi Miyawaki ◽  
Dhruv Khullar ◽  
Yusuke Tsugawa
Keyword(s):  
Hospital Mortality ◽  
Health Outcomes ◽  
Care Delivery ◽  
Bypass Graft ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Homeless Adults ◽  
To Receive

ObjectivesEvidence suggests that homeless patients experience worse quality of care and poorer health outcomes across a range of medical conditions. It remains unclear, however, whether differences in care delivery at safety-net versus non-safety-net hospitals explain these disparities. We aimed to investigate whether homeless versus non-homeless adults hospitalised for cardiovascular conditions (acute myocardial infarction (AMI) and stroke) experience differences in care delivery and health outcomes at safety-net versus non-safety-net hospitals.DesignCross-sectional study.SettingData including all hospital admissions in four states (Florida, Massachusetts, Maryland, and New York) in 2014.ParticipantsWe analysed 167 105 adults aged 18 years or older hospitalised for cardiovascular conditions (age mean=64.5 years; 75 361 (45.1%) women; 2123 (1.3%) homeless hospitalisations) discharged from 348 hospitals.Outcome measuresRisk-adjusted diagnostic and therapeutic procedure and in-hospital mortality, after adjusting for patient characteristics and state and quarter fixed effects.ResultsAt safety-net hospitals, homeless adults hospitalised for AMI were less likely to receive coronary angiogram (adjusted OR (aOR), 0.42; 95% CI, 0.36 to 0.50; p<0.001), percutaneous coronary intervention (aOR, 0.52; 95% CI, 0.44 to 0.62; p<0.001) and coronary artery bypass graft (aOR, 0.43; 95% CI, 0.26 to 0.71; p<0.01) compared with non-homeless adults. Homeless patients treated for strokes at safety-net hospitals were less likely to receive cerebral arteriography (aOR, 0.23; 95% CI, 0.16 to 0.34; p<0.001), but were as likely to receive thrombolysis therapy. At non-safety-net hospitals, we found no evidence that the probability of receiving these procedures differed between homeless and non-homeless adults hospitalised for AMI or stroke. Finally, there were no differences in in-hospital mortality rates for homeless versus non-homeless patients at either safety-net or non-safety-net hospitals.ConclusionDisparities in receipt of diagnostic and therapeutic procedures for homeless patients with cardiovascular conditions were observed only at safety-net hospitals. However, we found no evidence that these differences influenced in-hospital mortality markedly.

scholarly journals Mental health of undocumented migrants and migrants undergoing regularization in Switzerland: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julien Fakhoury ◽  
Claudine Burton-Jeangros ◽  
Liala Consoli ◽  
Aline Duvoisin ◽  
Delphine Courvoisier ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Disturbance ◽  
Legal Status ◽  
Cross Sectional Study ◽  
Self Report ◽  
Undocumented Migrants ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Anxiety Depression

Abstract Background Undocumented migrants live and work in precarious conditions. Few studies have explored the mental health consequences of such environment. The objective of this study is to describe the mental health of migrants at different stages of a regularization program. Methods This cross-sectional study included migrants undocumented or in the process of regularization. We screened for symptoms of anxiety, depression and sleep disturbance using validated tools. We created a composite outcome of altered mental health including these components plus self-report of a recent diagnosis of mental health condition by a health professional. Results We enrolled 456 participants of whom 246 (53.9%) were undocumented. They were predominantly women (71.9%) with a median age of 43.3 (interquartile range: 15.5) years, from Latin America (63.6%) or Asia (20.2%) who had lived in Switzerland for 12 (IQR: 7) years. Overall, 57.2% presented symptoms of altered mental health. Prevalence of symptoms of anxiety, depression and sleep disturbance were 36% (95% confidence interval: 31.6–40.6%), 45.4% (95% CI: 40.8–50.1%) and 23% (95% CI: 19.2–27.2), respectively. Younger age (adjusted odd ratio: 0.7; 95% CI: 0.5–0.9 for each additional decade), social isolation (aOR: 2.4; 95% CI: 1.4–4.2), exposure to abuse (aOR: 1.9; 95% CI: 1.1–3.5), financial instability (aOR: 2.2; 95% CI: 1.4–3.7) and multi-morbidity (aOR: 3.2; 95% CI: 1.7–6.5) were associated with increased risk of having altered mental health while being in the early stages of the process of regularization had no effect (aOR: 1.3: 95% CI: 0.8–2.2). Conclusions This study highlights the need for multi-pronged social and health interventions addressing the various domains of undocumented migrants living difficulties as complement to legal status regularization policies. Protection against unfair working conditions and abuse, access to adequate housing, promoting social integration and preventive interventions to tackle the early occurrence of chronic diseases may all contribute to reduce the burden of altered mental health in this group. More research is needed to assess the long-term impact of legal status regularization on mental health.

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