UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA

Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.

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Understanding the Non-medical Costs of Healthcare: Evidence from Inpatient Care for Older People in China

The China Quarterly ◽

10.1017/s0305741019001115 ◽

2019 ◽

Vol 242 ◽

pp. 487-507

Author(s):

Wei Yang

Keyword(s):

Older People ◽

Medical Costs ◽

Longitudinal Survey ◽

Rural Populations ◽

Substantial Part ◽

Medical Visits ◽

Using Data ◽

New Policies ◽

Health Payment ◽

Care For Older People

AbstractNon-medical costs, including costs associated with carers, travel, food and accommodation for family members who care for older people during their medical visits, can constitute a substantial part of total healthcare costs, especially for older people. Using data from the 2015 China Health and Retirement Longitudinal Survey, this study examines the effects of such non-medical costs on catastrophic health payments and health payment-induced poverty among older people in China. Results indicate that non-medical costs account for approximately 18 per cent of total inpatient costs. The percentage is highest for those in the lowest economic brackets. Rural populations are more likely than urban populations to incur catastrophic health payments and suffer from health payment-induced poverty. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. These findings suggest that policymakers should look to develop new policies that facilitate reimbursement of non-medical costs, particularly for the rural population.

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Drug Abuse and Cardiac Problem

Medicine Today ◽

10.3329/medtoday.v25i2.17928 ◽

2014 ◽

Vol 25 (2) ◽

pp. 90-92 ◽

Cited By ~ 1

Author(s):

Mohammad Shafiqur Rahman Patwary ◽

Kazi Abdullah Al Mamun

Keyword(s):

Health Care ◽

Central Nervous System ◽

Drug Abuse ◽

Health Care Systems ◽

Significant Proportion ◽

Lysergic Acid ◽

Prescription Stimulants ◽

Care Systems ◽

The Central Nervous System ◽

Medicine Today

Drug abuse has reached epidemic proportions in many countries including Bangladesh and threatens to overwhelm economic, social, and health care systems. In addition to their effects on the central nervous system, many of these agents induce profound changes in the heart and circulation that are responsible for a significant proportion of drug-related morbidity. Drugs that can affect the cardiovascular system are cocaine, heroin, inhalants, ketamine, lysergic acid diethylamide(LSD), marijuana,3,4-methylenedioxymethamphetamine(MDMA), methamphetamine, nicotine, phencyclidine (PCP), prescription stimulants, steroids .This article reviews the cardiovascular problems associated with drug abuse. DOI: http://dx.doi.org/10.3329/medtoday.v25i2.17928 Medicine Today 2013 Vol.25(2): 90-92

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Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need

Journal of Health Management ◽

10.1177/0972063421994992 ◽

2021 ◽

pp. 097206342199499

Author(s):

Sangay Thinley

Keyword(s):

Health Care ◽

Older People ◽

Long Term Care ◽

Health Care Systems ◽

Population Ageing ◽

Demographic Shift ◽

Term Care ◽

The Social ◽

Care Systems

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.

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Screening for psychiatric morbidity in the population - a comparison of the GHQ-12 and self-reported medication use

International Journal for Population Data Science ◽

10.23889/ijpds.v3i1.414 ◽

2018 ◽

Vol 3 (1) ◽

Cited By ~ 1

Author(s):

Foteini Tseliou ◽

Michael Donnelly ◽

Dermot O'Reilly

Keyword(s):

Health Care ◽

Older People ◽

Health Care Services ◽

Economic Status ◽

Health Care Systems ◽

Psychiatric Morbidity ◽

Medication Use ◽

Screening Tools ◽

Care Systems ◽

Population Mental Health

IntroductionUptake of psychotropic medication has been previously used as a proxy for assessing the prevalence of population mental health morbidity. However, it is not known how this compares with estimates derived from population screening tools. ObjectivesTo compare estimates of psychiatric morbidity derived by a validated screening instrument of psychiatric morbidity and a self-reported medication uptake measure. MethodsThis study used data from two recent population-wide health surveys in Northern Ireland, a country (UK) with free health services and no prescription charges. The psychiatric morbidity of 7,489 respondents was assessed using the GHQ-12 and self-reported use of medication for stress, anxiety and depression (sDAS medication). ResultsOverall, 19% of respondents were defined as ‘cases’ and 14.3% were taking sDAS medication. Generally, the two methods identified the same population distributions of characteristics that were associated with psychiatric morbidity though nearly as many non-cases as cases received sDAS medication (46.4% vs. 53.6%). A greater proportion of women and older people were identified as cases according to sDAS medication use, while no such variation was observed between socio-economic status and method of assessment. ConclusionsThis study indicates that these two methods of assessing population psychiatric morbidity provide similar estimates, despite potentially identifying different individuals as cases. It is important to note that different health care systems might be linked to variations in obstacles when accessing and using health care services. Highlights There was a reasonable correspondence between the different methods of assessment. A greater proportion of women and older people were identified as cases through the self-reported use of medication. An almost equal amount of GHQ-12 cases and non-cases reported being in receipt of medication.

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The journey of the frail older adult with heart failure: implications for management and health care systems

Reviews in Clinical Gerontology ◽

10.1017/s0959259814000136 ◽

2014 ◽

Vol 24 (4) ◽

pp. 269-289 ◽

Cited By ~ 12

Author(s):

George A Heckman ◽

Cara Tannenbaum ◽

Andrew P Costa ◽

Karen Harkness ◽

Robert S McKelvie

Keyword(s):

Heart Failure ◽

Health Care ◽

Older People ◽

Health Care Systems ◽

Functional Decline ◽

Care Utilization ◽

Care Systems ◽

Frail Older Adult ◽

Acute Care Utilization ◽

Failure Experience

SummaryThe heart failure epidemic predominantly affects older people, particularly those with concurrent co-morbid conditions and geriatric syndromes. Mortality and heath service utilization associated with heart failure are significant, and extend beyond the costs associated with acute care utilization. Over time, older people with heart failure experience a journey characterized by gradual functional decline, accelerated by unpredictable disease exacerbations, requiring greater support to remain in the community, and often ultimately leading to institutionalization. In this narrative review, we posit that the rate of functional decline and associated health care resource utilization can be attenuated by optimizing the management of heart failure and associated co-morbidities. However, to realize this objective, the manner in which care is delivered to frail older people with heart failure must be restructured, from the bedside to the level of the health care system, in order to optimally anticipate, diagnose and manage co-morbidities.

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