scholarly journals Burden of visual impairment associated with eye diseases: exploratory survey of 298 Chinese patients

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030561
Author(s):  
Xiaodong Guan ◽  
Mengyuan Fu ◽  
Fanghui Lin ◽  
Dawei Zhu ◽  
Daniel Vuillermin ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Economic Burden ◽  
Rural Areas ◽  
Health Utility ◽  
Medical Insurance ◽  
Direct Costs ◽  
Eye Diseases ◽  
Chinese Patients ◽  
Utility Value ◽  
Annual Household Income

ObjectivesTo explore the economic burden, prevalence of catastrophic healthcare expenditure (CHE) and the quality of life (QoL) of Chinese patients with visual impairment (VI) associated with eye diseases.DesignA questionnaire survey from March to May 2016 by structured face-to-face interviews of patients with VI.Participants302 patients who were diagnosed with moderate VI or worse in both eyes (visual acuity <6/18) were included, and 298 patients (98.7%) who completed the survey questionnaires were eligible for the study.Outcome measuresThe economic burden was estimated by calculating participants’ direct costs covered in 2015 and the definition of CHE was out-of-pocket (OOP) costs exceeding 30% of annual household income. QoL was weighed by health utility value using time-trade-off valuation techniques.ResultsAnnual average direct costs per patient caused by VI were US$6988.6±US$10 834.3, and 70.3% were direct medical costs of which only 26.9% were reimbursable by medical insurance. 32.2% of households that suffered from CHE, in particular, were less wealthy patients with VI living in rural areas and without medical insurance. The health utility value was rated at 0.65 on average, and patients with VI aged 51–57, living alone and insured by commercial medical insurance had relatively less QoL.ConclusionOur study explored the economic burden and QoL of VI associated with patients with eye diseases in China, indicating a substantial economic burden and poor QoL. Preferential medical insurance policies should be designed in relation to people with VI to further reduce the health inequalities, avoid CHE and promote QoL.

scholarly journals Analysis of the Effect of Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China: A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background: In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.Methods: The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7,353) whose annual serious illness expenses were between CNY 10,000 (1,414 USD) and CNY 30,000 (4,242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720).Results: The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P <0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P <0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = -0.016, P <0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.Conclusion: The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.

scholarly journals Analysis of the Effect of Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China: A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background: In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods: The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7,353) whose annual serious illness expenses were between CNY 10,000 (1,414 USD) and CNY 30,000 (4,242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720). Results: The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P <0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P <0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = -0.016, P <0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.Conclusion: The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.

scholarly journals Analysis of the Effect of Rural Residents Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China:A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background In 2003, China established a New Rural Cooperative Medical System(NRCMS) for rural residents, which had alleviated the burden of medical expenses of rural residents, but the reimbursement for high medical was insufficient. Therefore, China had gradually established a Serious Illness Insurance System (SIMIS) on the basis of NRCMS. After the payment of NRCMS, patients who met the requirements of SIMIS policy would be given a second payment to further alleviate the economic burden of patients with high medical expenses in rural areas. The purpose of this study is to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods Based on the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province from 2013 to 2016. We adopt descriptive and regression discontinuity (RD) method to analyze the payment effect of SIMIS. The RD analysis object (n = 7353) was the patients whose annual serious illness expenses were between CNY 10,000 and CNY 30,000, and the descriptive analysis object (n = 2720) was the patients compensated by SIMIS. Results The results of RD showed that the actual medical insurance payment proportion (AMIPP) increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion (IMSPP) increased by about 2% (lwald = 0.020, P < 0.10), outside medical insurance self-payment proportion (OMISPP) decreased by about 1.6% (lwald = -0.016, P < 0.05). The descriptive results showed that the serious illness patients mostly chose to go to hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out of pocket medical expenses were still high. Conclusion The medical technology level of Jinzhai County could not meet the needs of seriously illness patients, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of rural residents was insufficient. The high out of pocket expenses increased the possibility that people with good economic conditions could enjoy the reimbursement of SIMIS, resulting in inequity.

scholarly journals Analysis of the Effect of Rural Residents Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China:A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background In 2003, China established a New Rural Cooperative Medical System(NRCMS) for rural residents, which had alleviated the burden of medical expenses of rural residents, but the reimbursement for high medical was insufficient. Therefore, China had gradually established a Serious Illness Insurance System (SIMIS) on the basis of NRCMS. After the payment of NRCMS, patients who met the requirements of SIMIS policy would be given a second payment to further alleviate the economic burden of patients with high medical expenses in rural areas. The purpose of this study is to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods Based on the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province from 2013 to 2016. We adopt descriptive and regression discontinuity (RD) method to analyze the payment effect of SIMIS. The RD analysis object (n = 7353) was the patients whose annual serious illness expenses were between CNY 10,000 and CNY 30,000, and the descriptive analysis object (n = 2720) was the patients compensated by SIMIS. Results The results of RD showed that the actual medical insurance payment proportion (AMIPP) increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion (IMSPP) increased by about 2% (lwald = 0.020, P < 0.10), outside medical insurance self-payment proportion (OMISPP) decreased by about 1.6% (lwald = -0.016, P < 0.05). The descriptive results showed that the serious illness patients mostly chose to go to hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out of pocket medical expenses were still high. Conclusion The medical technology level of Jinzhai County could not meet the needs of seriously illness patients, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of rural residents was insufficient. The high out of pocket expenses increased the possibility that people with good economic conditions could enjoy the reimbursement of SIMIS, resulting in inequity.

scholarly journals Analysis of the Effect of Rural Residents Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China:A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background In 2003, China established a New Rural Cooperative Medical System(NRCMS) for rural residents, which had alleviated the burden of medical expenses of rural residents, but the reimbursement for high medical was insufficient. Therefore, China had gradually established a Serious Illness Insurance System (SIMIS) on the basis of NRCMS. After the payment of NRCMS, patients who met the requirements of SIMIS policy would be given a second payment to further alleviate the economic burden of patients with high medical expenses in rural areas. The purpose of this study is to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods Based on the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province from 2013 to 2016. We adopt descriptive and regression discontinuity (RD) method to analyze the payment effect of SIMIS. The RD analysis object (n = 7353) was the patients whose annual serious illness expenses were between CNY 10,000 and CNY 30,000, and the descriptive analysis object (n = 2720) was the patients compensated by SIMIS. Results The results of RD showed that the actual medical insurance payment proportion (AMIPP) increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion (IMSPP) increased by about 2% (lwald = 0.020, P < 0.10), outside medical insurance self-payment proportion (OMISPP) decreased by about 1.6% (lwald = -0.016, P < 0.05). The descriptive results showed that the serious illness patients mostly chose to go to hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out of pocket medical expenses were still high. Conclusion The medical technology level of Jinzhai County could not meet the needs of seriously illness patients, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of rural residents was insufficient. The high out of pocket expenses increased the possibility that people with good economic conditions could enjoy the reimbursement of SIMIS, resulting in inequity.

Economic burden of readmission due to postoperative cerebrospinal fluid leak in Chinese patients

2020 ◽  
Vol 9 (16) ◽  
pp. 1105-1115
Author(s):  
Shuqing Wu ◽  
Xin Cui ◽  
Shaoyu Zhang ◽  
Wenqi Tian ◽  
Jiazhen Liu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Generalized Linear Models ◽  
Economic Burden ◽  
Linear Models ◽  
Chinese Patients ◽  
Cerebrospinal Fluid Leakage ◽  
Index Hospitalization ◽  
Real World Data ◽  
Factors Associated ◽  
Hospitalization Cost

Aim: This real-world data study investigated the economic burden and associated factors of readmissions for cerebrospinal fluid leakage (CSFL) post-cranial, transsphenoidal, or spinal index surgeries. Methods: Costs of CSFL readmissions and index hospitalizations during 2014–2018 were collected. Readmission cost was measured as absolute cost and as percentage of index hospitalization cost. Factors associated with readmission cost were explored using generalized linear models. Results: Readmission cost averaged US$2407–6106, 35–94% of index hospitalization cost. Pharmacy costs were the leading contributor. Generalized linear models showed transsphenoidal index surgery and surgical treatment for CSFL were associated with higher readmission costs. Conclusion: CSFL readmissions are a significant economic burden in China. Factors associated with higher readmission cost should be monitored.

scholarly journals Economic Burden of Colorectal Cancer: A Case of Fars, Iran

2021 ◽  
Vol 28 ◽  
pp. 107327482110099
Author(s):  
Abdosaleh Jafari ◽  
Peyman Mehdi Alamdarloo ◽  
Mehdi Dehghani ◽  
Peivand Bastani ◽  
Ramin Ravangard
Keyword(s):  
Colorectal Cancer ◽  
Economic Burden ◽  
Purchasing Power Parity ◽  
Annual Cost ◽  
Low Cost ◽  
Direct Costs ◽  
Fars Province ◽  
Power Parity ◽  
Medical Sciences ◽  
The Mean

Among cancers, colorectal cancer is the third most common cancer in the world and the fourth leading cause of cancer deaths worldwide. Some studies have shown that the incidence of colorectal cancer is increasing in Iran and in Fars province. The present study aimed to determine the economic burden of colorectal cancer in patients referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences in 2019 from the patients’ perspective. This is a partial economic evaluation and a cost-of-illness study conducted cross-sectionally in 2019. All the patients with colorectal cancer who had been referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences, and had medical records were studied through the census method (N = 96). A researcher-made data collection form was used to collect the cost data. The prevalence-based and bottom-up approaches were also used in this study. The human capital approach was applied to calculate indirect costs. The mean annual cost per patient with colorectal cancer in the present study was $10930.98 purchasing power parity (PPP) (equivalent to 5745.29 USD), the main part of which was the medical direct costs (74.86%). Also, among the medical direct costs per patient, the highest were those of surgeries (41.7%). In addition, the mean annual cost per patient with colorectal cancer in the country was $ 116917762 PPP (equivalent to 61451621.84 USD) in 2019. Regarding the considerable economic burden of colorectal cancer and in order to reduce the costs, these suggestions can be made: increasing the number of specialized beds through the cooperation of health donors, establishing free or low-cost accommodation centers for patients and their companions near the medical centers, using the Internet and cyberspace technologies to follow up the treatment of patients, and increasing insurance coverage and government drug subsidies on drug purchase.

scholarly journals Prevalence and 11-year incidence of common eye diseases and their relation to health-related quality of life, mental health, and visual impairment

2021 ◽  
Author(s):  
Petri K. M. Purola ◽  
Janika E. Nättinen ◽  
Matti U. I. Ojamo ◽  
Seppo V. P. Koskinen ◽  
Harri A. Rissanen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Visual Impairment ◽  
Eye Diseases ◽  
Health Related Quality ◽  
Time Points ◽  
Related Quality ◽  
Health Related

Abstract Purpose To study the prevalence and incidence of the most common eye diseases and their relation to health-related quality of life (HRQoL), depression, psychological distress, and visual impairment in the aging population of Finland. Methods Our study was based on two nationwide health surveys conducted in 2000 and 2011. Eye disease status data were obtained from 7379 and 5710 individuals aged 30 + years, of whom 4620 partook in both time points. Both surveys included identical indicators of HRQoL (EuroQol-5 Dimension [EQ-5D], 15D), depression (Beck Depression Inventory [BDI]), psychological distress (General Health Questionnaire-12 [GHQ-12]), visual acuity, and self-reported eye diseases. We assessed the impact of known eye diseases on these factors, adjusted for age, gender, and co-morbidities. Results Prevalence of self-reported eye diseases was 3.1/2.7% for glaucoma, 8.1/11.4% for cataract, and 3.4/3.8% for retinal degeneration in 2000 and 2011, and the average incidence between 2000 and 2011 was 22, 109, and 35 /year/10,000 individuals, respectively. These eye diseases were associated with a significant decrease in EQ-5D and 15D index scores in both time points. BDI and GHQ-12 scores were also worsened, with some variation between different eye diseases. Impaired vision was, however, the strongest determinant of declined HRQoL. During the 11-year follow-up the effect of eye diseases on HRQoL and mental health diminished. Conclusion Declined HRQoL associated with eye diseases is more related to impaired vision than the awareness of the disease itself, and this declining effect diminished during the follow-up. Therefore, information directed to the public on the risks and prevention of blindness can and should be strengthened to prevent the deleterious effects of visual impairment.

scholarly journals Kelainan refraksi pada siswa SMP daerah pedesaan

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Indo Mamesah ◽  
Josefien S. M. Saerang ◽  
Laya M. Rares
Keyword(s):  
High School Students ◽  
Visual Impairment ◽  
Urban Area ◽  
Rural Area ◽  
Junior High School ◽  
Rural Areas ◽  
Functional Limitation ◽  
Visual Field Loss ◽  
School Students ◽  
Cross Sectional

Abstract: Visual impairment is defined as a functional limitation of the eye/eyes or visual system and can manifest in decreased visual acuity or contrast sensitivity, visual field loss, photophobia, visual distortion, visual perceptual difficulties, or a combination of them. Examination of the eye and vision assessment are very important to detect conditions that can cause blindness and serious systemic conditions, which cause problems in school performance, or at a more severe level, life threatening. This study aimed to obtain the occurence of refractive anomalies among junior high school students in rural areas. This was an analytical observational study with a cross-sectional design. The study was conducted in SMP I Wori (rural area) and SMP I Airmadidi (urban area). There were 60 respondents; 30 respondents of each school. Distributions of respondent genders were nearly the same for both schools; the number of females was higher than males. The majority of SMP I Airmadidi students were 11 years old (36.7%), meanwhile the majority of SMP Wori students were 13 years (50%). Most student complaints in SMP I Airmadidi were itchy eyes and drowsiness (16.7%), meanwhile in SMP I Wori was headache (18.4%). Visual impairment was found in 16.6% of students of SMP I Airmadidi, meanwhile in SMP I there was no student with refractive anomaly. Conclusion: There was no refractive anomaly found among students of rural area, however, among students of urban area myopia was the refractive anomaly found.Keywords: refractive anomalyAbstrak: Gangguan penglihatan didefinisikan sebagai suatu keterbatasan fungsional pada mata atau kedua mata atau sistem visual yang dapat bermanifestasi terhadap penurunan ketajaman penglihatan atau sensitifitas kontras, hilangnya lapangan penglihatan, photofobia, distorsi visual, kesulitan perseptual visual atau kombinasi dari semua diatas. Pemeriksaan mata dan penilaian penglihatan sangat penting untuk mendeteksi kondisi yang dapat menyebabkan kebutaan dan kondisi sistemik serius, yang memicu masalah performa di sekolah, atau pada tingkat yang lebih berat, mengancam kehidupan anak. Penelitian ini bertujuan untuk mengetahui gambaran kelainan refraksi pada anak SMP di daerah pedesaan. Jenis penelitian ini analitik observasional dengan desain potong lintang. Penelitian dilakukan di SMPN I Wori (daerah luar Minahasa Utara/pedesaan) dan SMPN I Airmadidi (kota Kabupaten Minahasa Utara), dan diperoleh 60 responden penelitian. Distribusi jenis kelamin responden kedua sekolah hampir sama dimana jumlah perempuan lebih banyak dari laki-laki. Usia terbanyak di SMPN I Airmadidi ialah 11 tahun (36,7%) sedangkan di SMPN Wori 13 tahun (50%). Keluhan terbanyak siswa di SMPN I Airmadidi ialah mata gatal dan rasa kantuk (16,7%), sedangkan di SMPN I Wori ialah sakit kepala (18, 4%). Gangguan penglihatan ditemukan pada responden di SMPN I Airmadidi sebanyak 16,6 % sedangkan di SMPN I tidak ditemukan kelainan visus. Simpulan: Tidak ditemukan adanya gangguan refraksi pada siswa SMP di daerah pedesaan. Kelainan refraksi miopia ditemukan pada siswa SMP di perkotaan.Kata kunci: gangguan refraksi

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