Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

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Prevalence of Soil Transmitted Helminthes (STH) Infection among Children Aged 2-17 Years in Urban and Rural Areas of Dhaka District in Bangladesh

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v5i2.16933 ◽

2013 ◽

Vol 5 (2) ◽

pp. 16-22 ◽

Cited By ~ 5

Author(s):

Sultana Shahana Banu ◽

Be-Nazir Ahmed ◽

Shamim Jubayer ◽

Sultana Gulshana Banu ◽

Khorsed Ara ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Strongyloides Stercoralis ◽

Cross Sectional Study ◽

Single Infection ◽

Double Infection ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Urban Study

A multi-staged cross sectional study was conducted among children aged 2 -17 years to assess the level of soil transmitted helminthes (ST H) infections and its relation to socio-demographic characteristics among them. Two thousand children were randomly selected from two rural and four different communities of urban areas of Dhaka district since November 2009 to June 2010. Four different communities classified as higher, medium, poorer and slum/ low socio-economic groups from urban areas were selected on the basis of their place of residence with different socio-economic status. Urban study subjects were again sub grouped into upper (higher and medium socio-economic) and lower (poorer and slum/low socio-economic) classes. Stool specimens of the respondents were collected and tested at the Parasitology department of I E DCR , using the Kato-katz faecal technique for identification of helminthes eggs following their morphology (A. lumbricoides, Ttrichiura, and A. duodenale), and larval stage (S. stercoralis). About 32.15% study population harbored at least one of the four helminthes species. Baseline prevalence of infections and mean parasite loads for Ascaris lumbricoides were 40.61% and 600.80 e/g, for Trichuris trichiura 30.42% and 206.11e/g, and for A. duodenale 6.80% and 78.75 e/g. Three children (0.49%) were positive for Strongyloides stercoralis. Single infection of 78.32 % and double infection of 21.68 % were recorded. Single infection of A. lumbricoides (40.61%) and T trichiura (30.42%) and double infection of A. lumbricoides - T trichiura (18.61%) were more prevalent. T he prevalence of ST H infection was 25.47 % and 38.68 % for rural and urban areas respectively (P<.001). Among urban study subjects, the distribution of ST H infection was 0.0 % in the higher (living in higher socioeconomic areas) (only 3 samples could be collected), 26.75 % in medium (living in medium socio-economic areas), 45.95 % in poorer and 50.54 % in slum/low socio-economic groups. Significantly higher number of ST H infection was observed among lower than that in upper socio-economic classes (P <.001). These results suggest that ST H infections remain a serious health problem among children in Bangladesh and need appropriate prevention and control measures.DOI: http://dx.doi.org/10.3329/bjmm.v5i2.16933 Bangladesh J Med Microbiol 2011; 05 (02): 16-22

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The Prevalence of Household Catastrophic Health Expenditure in Nigeria: A Rural-Urban Comparison

Journal of Health and Medical Sciences ◽

10.31014/aior.1994.04.02.160 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

Paul Oladapo Ajayi ◽

◽

Demilade Olusola Ibirongbe ◽

Tope Michael Ipinnimo ◽

Oluremi Olayinka Solomon ◽

...

Keyword(s):

Urban Communities ◽

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Univariate Analysis ◽

Sampling Technique ◽

Catastrophic Health Expenditure ◽

Cross Sectional ◽

Rural And Urban ◽

Household Heads

Background: Catastrophic health expenditure occurs when the burden of Out-of-pocket health expenditure has reached a certain level that a household must forego the expenditure on other basic needs of life to meet the health expenses of its member(s) of the household. Worldwide, over 44 million households suffer annually from financial catastrophe. This study intends to determine the prevalence of household catastrophic health expenditure amongst rural and urban communities in Ekiti, Nigeria. Methodology: This is a comparative cross-sectional study of households within selected rural and urban communities in Ekiti State, Nigeria. A pre-tested interviewer-administered semi-structured questionnaire was used to collect data over a period of 4 months from a sample of 1,000 household heads, using a multistage sampling technique. Data obtained were then entered using the SPSS version 20 and analysed with STATA 12. Two different methodologies were used to calculate household catastrophic health expenditure, with sensitivity analysis done. Univariate analysis were used to describe the population in relation to relevant variables. Result: The prevalence of household catastrophic health expenditure is high using the two methodological calculations. It was significantly higher in the rural areas, 18.5% than the urban areas, 12.8% (p=0.015) for first method; it was also higher in the rural areas, 8.3% compared to the urban areas, 2.5% (p<0.001) for the second method. Conclusion: Prevalence of household catastrophic health expenditure is high in Nigeria, but worse in the rural areas. It’s therefore vital to establish financial and social intervention mechanisms that can protect households from incurring catastrophic health expenditure.

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Post-partum psychosis: socio-demographic and obstetric profile

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175503 ◽

2017 ◽

Vol 6 (1) ◽

pp. 106

Author(s):

Sunil Kumar Ahuja ◽

Nimisha Mishra ◽

Pradeep Kumar

Keyword(s):

Rural Areas ◽

Nuclear Family ◽

Post Partum ◽

Economic Status ◽

Cross Sectional Study ◽

Vulnerable Groups ◽

Puerperal Psychosis ◽

Cross Sectional ◽

Medical College ◽

History Of

Background: Better knowledge of socio-demographic profile and obstetric features may help in early identification and treatment of patients with post-partum psychosis. The aim of present research is to study the age, parity, socio-demographic and obstetric and menstrual profile of patients suffering from post-partum psychosis. Setting and Design: A cross-sectional study at in-patient department of psychiatry, SS Medical College and associated SGMH Rewa.Methods: The study was conducted on sixty patients of post-partum psychosis admitted in psychiatry ward. Detailed socio-demographic characteristics, obstetric and menstrual profile along with psychiatric assessment were recorded in proforma specially designed for the study.Results: Bulk of our post partum psychotic subjects (60%) were in the age range of 18-25 years with 83.33% of women were residing at rural areas. Most of subjects (76.67%) of post partum psychosis were illiterate. 73.33% patient were belonging to low socio-economic status and remaining to middle and high socioeconomic status. Majority of subjects (13.33%) were house wife (86.67%) followed by laborer class. Family jointness reveal 80% and 20% of subjects trailed from joint and nuclear family respectively. the maximum number of subjects (60%) were primipara with only 13.33% of subjects had history of obstetric complication in form of prolonged labour and post-partum heamorrhage. 25% subjects had cesarean delivery. 40% patients of puerperal psychosis were having menstrual irregularity and 60% had regular menstruation.Conclusions: Screening of vulnerable groups i.e. younger age, primipara, history of irregular menstruation in post partum period for psychiatric sign and symptoms is requisite for early diagnosis and prompt and adequate management. As most of the patients were from rural areas it is necessary to establish psychiatric services in rural areas as well so that this group of population can be provided holistic care along with already existing medical services.

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Assessment of glycaemic control among self-reported cases of diabetes: an observation of a PPP model project

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20180237 ◽

2018 ◽

Vol 5 (2) ◽

pp. 611

Author(s):

Jagruti Prajapati ◽

Jaydip Oza ◽

B. B. Patel ◽

Sunil R. Avashia

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

Partnership Model ◽

Sociodemographic Determinants ◽

Urban Rural ◽

Diabetes Outcome

Background: Sociodemographic determinants of diabetes such as age, sex and socioeconomic status play a major role in diabetes outcome. It was necessary to design a research project to address this. The aim of this study is to determine the prevalence of diabetes and its sociodemographic factors such as age, gender, residential area, economic status and a level of education in the project districts. Methods: The cross sectional study was carried out in the project districts named Ahmedabad, Dahod and Valsad. Urban, rural and tribal population are above 30 years of age from different districts were covered to collect data on socio economic back ground and status of diabetes. Random blood sugar was measured by glucometer and glycosylated haemoglobin (HbA1c) by the HbA1c analyzer. Results: Proportion of male and female participants were near to equal. Percentage of self reported cases of diabetes (including controlled and uncontrolled) was 14.07% in urban areas while it was 5.24% in rural areas. Pre diabetes detection rate was more in rural area. During screening 11.83% of pre diabetes cases were identified. Difference between controlled and uncontrolled diabetes among illiterate and literate groups was statistically not significant. Conclusions: This preliminary observational study included more than 51000 participants visiting primary and community health centres from three districts of Gujarat. The public private partnership model helped in systematic approach towards screening and data collection. The study reported prediabetes cases higher than global prevalence. More controlled studies are required to define the mandatory screening protocol in resource constrained settings.

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The Prevalence of Household Catastrophic Health Expenditure in Nigeria: A Rural-Urban Comparison

10.31219/osf.io/k6x4f ◽

2021 ◽

Author(s):

Paul Oladapo Ajayi ◽

Demilade Olusola Ibirongbe ◽

Tope Michael Ipinnimo ◽

Oluremi Olayinka Solomon ◽

Austin Idowu Ibikunle ◽

...

Keyword(s):

Urban Communities ◽

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Univariate Analysis ◽

Sampling Technique ◽

Catastrophic Health Expenditure ◽

Cross Sectional ◽

Rural And Urban ◽

Household Heads

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Has Iran achieved the goal of reducing the prevalence of households faced with catastrophic health expenditure to 1%? The results of a national study

10.21203/rs.3.rs-847322/v1 ◽

2021 ◽

Author(s):

Bakhtiar Piroozi ◽

Hassan Mahmoodi ◽

Hossein Safari ◽

Amjad Mohamadi Bolbanabad ◽

Satar Rezaei ◽

...

Keyword(s):

Health Expenditure ◽

Economic Status ◽

Multivariate Regression Analysis ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

World Health ◽

National Study ◽

Health Coverage ◽

World Health Survey ◽

Cross Sectional

Abstract Background Access to universal health coverage and reducing the prevalence of catastrophic health expenditure (CHE) to 1% are the commitments of the Islamic Republic of Iran. The aim of this study was to investigate the prevalence of households exposed to CHE. Methods This cross-sectional study was performed on 2000 households in five provinces of Iran in 2021. Data were collected through interviews using the World Health Survey questionnaire. Results Data from households whose health care costs were more than 40% of their capacity to pay were included in the group of households with CHE. Determinants of CHE were identified using multivariate regression analysis. 8.3% of households were exposed to CHE. The variables of being a female head of household, use of inpatient, outpatient, dental, and rehabilitation services, families with disabled members and low economic status of the households were significantly associated with increased odds of facing CHE. Conclusion In the final year of the sixth five-year development plan, Iran has not yet achieved its goal of "reducing the percentage of households exposed to CHE to 1%," and a high percentage of Iranian households still face CHE. Policymakers should pay attention to factors increasing the chance of facing CHE in designing interventions and this can help the goal of financial protection against health costs.

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Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients : evidence from China Family Panel Studies

10.21203/rs.3.rs-37742/v1 ◽

2020 ◽

Author(s):

Xianzhi Fu ◽

Qi-wei Sun ◽

Chang-qing Sun ◽

Fei Xu ◽

Jun-jian He

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Communicable Disease ◽

Rural Households ◽

Catastrophic Health Expenditure ◽

System Reform ◽

Cross Sectional ◽

Urban Rural ◽

Panel Studies

Abstract Background: The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.Methods: The second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.Results: The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).Conclusions: Compared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics.

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Prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka: a community-based, cross-sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204950 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4799

Author(s):

Basanagouda K. Patil ◽

Vijay S. Patil ◽

A. Nagrajachari ◽

D. Kiran ◽

Sunita B. Patil

Keyword(s):

Tobacco Use ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Cross Sectional Study ◽

Family Type ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Demographic Correlates

Background: Tobacco use is the single, largest preventable cause of death and disability worldwide. Area-specific community-based epidemiological studies on tobacco use are required to quantify the problem, identify the determinants and their distribution. The objectives were to find out the prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka, India.Methods: This was a community-based, cross-sectional study of 2008 subjects (>10 years of age) in urban and rural areas of Davangere taluka, Karnataka. Interviews were conducted by using a structured, pre-tested questionnaire by house-house visits. Results are presented using percentages, chi-square test, odds ratio and multiple logistic regression analysis.Results: The prevalence of tobacco use was 30.7%. Among urban males it was 39.5%, rural males 39.6%, rural females 26% and urban females 18.5%. Tobacco use was significantly associated with sex, locality, religion, caste, marital status, family type, occupation, and tobacco use in family or friends. There was direct relationship of tobacco use with age and inverse relationship with education and socio-economic status. Mixed tobacco use was higher in rural areas compared to urban areas. About 73.9% of 10-29 years persons had started before the age of 18 years. Among older participants there was higher frequency of consumption and duration of use.Conclusions: Tobacco use is common and it is influenced by various local socio-demographic factors. Addressing these factors and providing tobacco cessation services should be included as key strategies in tobacco control.

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The Romanian Version of Health-Related Quality of Life Questionnaire 12 for Chronic Otitis Media. The Socio-Economic Status Impact Significance

ROMANIAN BIOTECHNOLOGICAL LETTERS ◽

10.25083/rbl/26.2/2455.2463 ◽

2021 ◽

Vol 26 (2) ◽

pp. 2455-2463

Author(s):

ALMA AURELIA MANIU ◽

◽

CRISTIAN FLETAN ◽

VLAD ANDREI BUDU ◽

VIOLETA NECULA

Keyword(s):

Otitis Media ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Chronic Otitis Media ◽

Cross Sectional Study ◽

Primary Objective ◽

P Value ◽

Life Questionnaire ◽

Cross Sectional

Objective: Our primary objective was to translate and validate Chronic Otitis Media (COM) Questionnaire-12 (COMQ-12) in Romanian. The secondary objective was to investigate the effect of the socioeconomic status on the preoperative COMQ-12 scores in individuals with a similar stage of disease. Methods: This was a cross-sectional study. Patients diagnosed with different stages of (COM) with cholesteatoma, scheduled for the first surgery, filled in the Romanian translated version of the COMQ-12. The patients were divided according to the stage of the disease and the environment of origin: rural versus urban areas. Results: The internal consistency of the Romanian COMQ-12 proved excellent, with a Cronbach’s alpha equal to 0.959. The correlation of the 24 randomly split-half reliability analysis varied from 0.904 to 0.917, with a mean of 0.908. Significantly higher COMQ-12 scores are obtained by patients from urban (mean = 42.14, SD =9.04) as compared to those from rural (mean = 30.44, SD = 5.88) only for those with stage III disease (P-value=0.0292). Conclusions: Romanian version of COMQ-12 proved to be a valid instrument that can be use in clinical practice to provide suitable information in COM patients, which contributes to the development of an international common otology dataset. Patients from rural areas tend to disregard their symptoms, being more predisposed to potential complications related to COM rather than urban patients at the same stage of the disease.

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Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

10.21203/rs.3.rs-82474/v1 ◽

2020 ◽

Author(s):

Xian-zhi Fu ◽

Qi-wei Sun ◽

Chang-qing Sun ◽

Fei Xu ◽

Jun-jian He

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Communicable Disease ◽

Rural Households ◽

Catastrophic Health Expenditure ◽

System Reform ◽

Cross Sectional ◽

Urban Rural ◽

Panel Studies

Abstract BackgroundThe prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.MethodsThe second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.ResultsThe CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).ConclusionsCompared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics mentioned above.

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