The health status and insurance affiliation of stateless children in Tak Province, Thailand

2020 ◽  
Vol 13 (3) ◽  
pp. 219-238
Author(s):  
Proloy Barua ◽  
Kanida Charoensri Narattharaksa
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Health Outcomes ◽  
Statistical Significance ◽  
Experimental Studies ◽  
Sensitivity Analyses ◽  
Content Type ◽  
District Hospitals ◽  
Tak Province ◽  
Uninsured Children

Purpose Statelessness is the worst possible form of violation of fundamental human rights which can lead to improper health systems management and serious adverse health outcomes in children. To address this, the Thai Cabinet introduced the Health Insurance for People with Citizenship Problem (HIPCP) in 2010. The purpose of this study is to examine the association between insurance affiliations and the health status of stateless children insured with the HIPCP. The presence of pneumonia was selected as a proxy for health status. The comparison groups were Thai children insured with the Universal Coverage Scheme (UCS) which was launched in 2002 and the uninsured children of low-skilled migrants in Thailand. Design/methodology/approach A retrospective study was conducted at four selected district hospitals: Mae Ramat Hospital, Phop Phra Hospital, Tha Song Yang Hospital and Umphang Hospital in Tak Province, located in northwestern Thailand. The study used the medical records of children aged 0-15 years who were admitted to the aforementioned hospitals between January 1, 2013 and December 31, 2017. Multivariate logistic regression model was applied with a binary response variable (ever diagnosed with pneumonia: yes/no). Exposure was three types of insurance status (uninsured, HIPCP and UCS) while covariates were age, sex, domicile and year of hospitalization of children. Findings Of 7,098 hospitalized children between 2013 and 2017, 1,313 were identified with pneumonia. After controlling for key covariates, multivariate results depicted that the odds of pneumonia was 4 per cent higher in stateless children insured with the HIPCP as compared with uninsured children but non-significant (adjusted odds ratio [AOR] = 1.040, 95 per cent confidence interval [CI] = [0.526, 2.160], p = 0.916). Similarly, the odds of pneumonia was 10 per cent higher in Thai children insured with the UCS as compared with uninsured children but non-significant (AOR = 1.100, 95 per cent CI = [0.594, 2.180], p = 0.767). The children who were hospitalized in 2017 were 26 per cent more likely to have pneumonia as compared with those who were hospitalized in 2013 with statistical significance (AOR = 1.260, 95 per cent CI = [1.000, 1.580], p = 0.050). Results remained robust after performing sensitivity analyses. Social implications This study suggests that health insurance is not associated with the health status of vulnerable children especially in the presence of multiple health interventions for uninsured and/or undocumented children living along the Thai–Myanmar border area. Further experimental studies are warranted to understand the causal relationship between insurance and health outcomes and to overcome the limitations of this observational study. Originality/value This study has discovered that age and domicile of children are independently associated with pneumonia. In comparison with the youngest age group (0-1 year), the older age groups presented a significantly lower odds for pneumonia. The children living in Phop Phra, Tha Song Yang and Umphang districts revealed a reduced risk for pneumonia as compared with children living in Mae Ramat district.

scholarly journals Healthy aging in India: evidence from a panel study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
C.V. Irshad ◽  
Umakant Dash
Keyword(s):  
Health Policy ◽  
Health Status ◽  
Health Outcomes ◽  
Healthy Aging ◽  
Protective Factor ◽  
Disease Incidence ◽  
Panel Study ◽  
National Level ◽  
Average Life Expectancy ◽  
Content Type

PurposeRecent public health policy emphasizes the achievement of healthy aging as average life expectancy increases worldwide. Evidence for healthy aging from low- and middle-income countries (LMIC) is limited. The purpose of this paper is to assess the prospects of healthy aging and its associated factors in the Indian context.Design/methodology/approachThe study was based on a national-level panel survey, the Indian Human Development Survey (IHDS) conducted in 2004-05 and 2011-12. The analytical sample consists of 10,218 elderly individuals who were 60 years old and above at the baseline. Change in health status was assessed based on disability and disease incidence at the follow-up. A generalized estimating equation (GEE) model was performed to assess health status change.FindingsIncreasing age was a risk factor for all dimensions of health outcomes. Elderly from the lowest wealth quintiles were more likely to lose health due to short-term morbidity, whereas the highest wealth quintiles were more likely to lose health due to long-term and multi-morbidity, indicating evidence for the presence of the “disease of affluence”. Social capital, such as living in a joint family acted as a protective factor against health risks.Originality/valueWith the results showing the evidence of the “disease of affluence” and “disease of poverty” in different health outcomes, there should be a health policy focus that copes with undergoing epidemiological transition. It is also important to pay attention to health-protecting factors such as social and familial support to achieve healthy aging.

Association between Health Insurance and Incidence of Death in Stateless Children in Tak Province, Thailand

2020 ◽  
Vol 22 (3) ◽  
pp. 348-362
Author(s):  
Proloy Barua ◽  
Kanida Narattharaksa
Keyword(s):  
Health Insurance ◽  
Universal Coverage ◽  
Outcome Variable ◽  
Risk Of Death ◽  
Study Results ◽  
Public Health Office ◽  
Tak Province ◽  
Uninsured Children ◽  
Death Cases ◽  
Universal Coverage Scheme

This study assesses the association between health insurance and incidence of death in stateless children compared with uninsured children in Tak Province in Thailand. The study used electronic medical records of children aged between 0 and 15 who registered with selected health facilities between 01 January 2013 and 31 December 2017. The required data was obtained from ‘43-files database’ through the Provincial Public Health Office. The death case was used as a binary outcome variable while the exposure was three types of insurance: uninsured, stateless and the Universal Coverage Scheme (UCS). The age, sex and domicile of the children were used as covariates in the multivariate logistic regression. Of 164,435 registered children, 824 death cases were found during the study period. The study results suggest that insurance is associated with the reduced risk of deaths in stateless children. The odds of death is 86 per cent lower in the stateless insurees than in the uninsured children (adjusted odds ratio [AOR] = 0.242, 95% confidence interval [CI] = [0.136,0.403]; p < 0.001). The death is 69 per cent lower in the UCS beneficiaries than in the uninsured children (AOR = 0.385,95 per cent CI = [0.308,0.489]; p < 0.001). Age, sex and domicile of the children were independently associated with a varying risk of death.

An inquiry into the achievements in health outcomes of Bangladesh: role of health expenditure, income, governance and female education

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tahmina Sultana ◽  
Faroque Ahmed ◽  
Mohammad Tareque
Keyword(s):  
Health Outcomes ◽  
Health Expenditure ◽  
Statistical Significance ◽  
Health Indicators ◽  
Female Education ◽  
Social Responsiveness ◽  
Content Type ◽  
Distributed Lag ◽  
Per Capita ◽  
Enrolment Ratio

Purpose Bangladesh is applauded for its achievement in various health and social outcomes though criticized for its failure in properly dealing with governance issues. The purpose of this paper is intends to see how the health outcomes (in case of life expectancy, under-five mortality and adolescent fertility) are impacted by health expenditure (both public and private), per capita income in presence of overall governance and female education. This paper assumes that rapid progress in female education reflects the Bangladeshis’ social responsiveness to change. Design/methodology/approach This paper uses autoregressive distributed lag technique to estimate the models with data ranges from 1990 to 2016 under two different scenarios. Findings This study has found that all the explanatory variables exert significant impact on health outcomes. Furthermore, public health expenditure is augmented with a composite governance issue, and this enhances robustness as well as statistical significance of the models. These suggest that the governance issues play a very crucial role to achieve the expected health outcomes. Female secondary enrolment ratio appears with improved coefficients in terms of sign and magnitude for all the health indicators. Originality/value This paper contributes to the existing literature showing econometric evidence that highlights the importance of governance and female education in improving health outcomes of Bangladesh apart from health expenditure and per capita gross domestic product.

scholarly journals Individual and Community Socioeconomic Status: Impact on Mental Health in Individuals with Arthritis

Arthritis ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Chivon A. Mingo ◽  
Kathryn R. Martin ◽  
Jack Shreffler ◽  
Britta Schoster ◽  
Leigh F. Callahan
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Health Status ◽  
Health Outcomes ◽  
Statistical Significance ◽  
Epidemiological Studies ◽  
Community Level ◽  
Mental Health Outcomes ◽  
Outcome Variable ◽  
The Impact

To examine the impact of individual and community socioeconomic status (SES) measures on mental health outcomes in individuals with arthritis, participants with self-reported arthritis completed a telephone survey assessing health status, health attitudes and beliefs, and sociodemographic variables. Regression analyses adjusting for race, gender, BMI, comorbidities, and age were performed to determine the impact of individual and community level SES on mental health outcomes (i.e., Medical Outcomes Study SF-12v2 mental health component, the Centers for Disease Control and Prevention Health-Related Quality of Life Healthy Days Measure, Center for Epidemiological Studies Depression [CES-D] scale). When entered singly, lower education and income, nonmanagerial occupation, non-homeownership, and medium and high community poverty were all significantly associated with poorer mental health outcomes. Income, however, was more strongly associated with the outcomes in comparison to the other SES variables. In a model including all SES measures simultaneously, income was significantly associated with each outcome variable. Lower levels of individual and community SES showed most consistent statistical significance in association with CES-D scores. Results suggest that both individual and community level SES are associated with mental health status in people with arthritis. It is imperative to consider how interventions focused on multilevel SES factors may influence existing disparities.

Oral Health Status and Oral Health Services Utilization of Myanmar Residents in Japan

2019 ◽  
Vol 31 (1) ◽  
pp. 81-86
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Oral Health ◽  
Periodontal Disease ◽  
Health Care Services ◽  
Health Knowledge ◽  
Oral Health Status ◽  
Services Utilization ◽  
Periodontal Index ◽  
The Status

The purpose of this study was to investigate oral health status and oral health care services utilization among Myanmar residents in Japan. A crosssectional epidemiological study was performed among 152 Myanmar residents aged 18 to 67 years in Tokyo, Japan. Clinical oral examinations and questionnaire surveys were conducted from June to July, 2017. Caries prevalence for all participants was 70.4% with mean decayed, missing, and filled teeth (DMFT) of 2.72±2.91. The prevalence of periodontal disease (Community Periodontal Index - CPI code 1) for all participants was 93.4%. A total of 67 participants (44.1%) had the experience of dental visits in Japan. Most participants (84.2%) had Japanese health insurance, and the participants with health insurance had a significantly higher number of filled teeth than those without (p=0.036). DMFT (p=0.020) and the prevalence of periodontal disease (p=0.049) were significantly lower in participants with health insurance than in those without. Further, self-perceived oral health was better in participants with health insurance than those without (p=0.001). The status of health insurance was indicated to influence on oral health status. In order to promote oral health and facilitate on owning health insurance to Myanmar residents in Japan, oral health education also should be provided to enhance their oral health knowledge.

The Relationship Between The Perception of Elderly’s Health Status and Health Behaviors in Nakhon Nayok Province, Thailand

2019 ◽  
Vol 12 (1) ◽  
pp. 420-423
Author(s):  
Prapada Watcharanat ◽  
Prasong Tanpichai ◽  
Ravee Sajjasophon
Keyword(s):  
Regression Analysis ◽  
Health Status ◽  
Health Behaviors ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Statistical Significance ◽  
The Elderly ◽  
Cross Sectional ◽  
Congenital Diseases ◽  
The Relationship

Purpose: This research aims to study the relationship between perception of elderly’s health and health behaviors in Nakhon Nayok province, Thailand Methods: This research was a cross-sectional study. The questionnaire was used to collect the data. This research was conducted in Nakhon Nayok province. The sample size was 270 which applied Taro Yamane's formula at a significant level 0.05. The descriptive statistics was implemented to describe the variables by presenting the frequency, percentage, mean and standard deviation. Furthermore, multiple regression analysis was applied to analyze the relationship between perception of elderly’s health and health behaviors. The statistical significance was considered to reject Hypothesis-null at < 0.05. Results: From a total of 270 people, more than 58.22% of the elderly perceived that they had moderate health conditions. Most elderly had congenital diseases (62.2%). The multiple regression analysis results showed that health status perception and health status perception when compared to their cohort related significantly to health behavior. Conclusion: The government should support the elderly on participation, trust, engagement, and cultural concern of the people in the community, which can contribute to promoting the physical, mental and social condition of the elderly.

Gaining and Losing Health Insurance: Strengthening the Evidence for Effects on Access to Care and Health Outcomes

2000 ◽  
Vol 57 (3) ◽  
pp. 298-318 ◽  
Author(s):  
Judith D. Kasper ◽  
Terence A. Giovannini ◽  
Catherine Hoffman
Keyword(s):  
Health Insurance ◽  
Health Outcomes ◽  
Access To Care

scholarly journals Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Li ◽  
Jingdong Xu ◽  
Huan Zhou ◽  
Hua You ◽  
Xiaohui Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Status ◽  
Health Outcomes ◽  
Working Conditions ◽  
Health Workers ◽  
Front Line ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

scholarly journals Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdelhafid Benksim ◽  
Rachid Ait Addi ◽  
Elhassania Khalloufi ◽  
Aziz Habibi ◽  
Mohamed Cherkaoui
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Nutritional Status ◽  
Statistical Significance ◽  
Well Being ◽  
Public Institution ◽  
Subjective Well Being ◽  
Number Of Children ◽  
Significant Difference ◽  
Nutritional Characteristics

Abstract Background As the world’s population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. Methods This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. Results Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). Conclusions This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.

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