Direct non-medical and indirect costs of diabetes and its associated complications in Vietnam: an estimation using national health insurance claims from a cross-sectional survey

ObjectiveThe prevalence of diabetes in Vietnam has increased from 2.5% in 2007 to 5.5% in 2017, but the burden of direct non-medical and indirect costs is unknown. The objective of this study was to estimate the direct non-medical costs and indirect costs due to type 2 diabetes mellitus (T2DM) and its associated complications among Vietnam Health Insurance System (VHIS) enrollees in Vietnam.DesignThe first phase was a cross-sectional survey of patients with T2DM. In the second phase, data from the previous phase were used to predict direct non-medical costs and presenteeism costs of VHIS enrollees diagnosed with T2DM based on demographic and clinical characteristics in 2017. The human-capital approach was used for the calculation of indirect costs.Setting and participantsThis study recruited 315 patients from a national hospital, a provincial hospital and a district hospital aged 18 or above, diagnosed with T2DM, enrolled in VHIS, and having at least one visit to hospitals between 1 June and 30 July 2018. The VHIS dataset contained 1,395,204 patients with T2DM.Outcome measuresThe direct non-medical costs and presenteeism were collected from the survey. Absenteeism costs were estimated from the VHIS database. Costs of premature mortality were calculated based on the estimates from secondary sources.ResultsThe total direct non-medical and indirect costs were US$239 million in 2017. Direct non-medical costs were US$78 million, whereas indirect costs were US$161 million. Costs of absenteeism, presenteeism and premature mortality corresponded to 17%, 73% and 10% of the indirect costs. Patients incurred annual mean direct non-medical costs of US$56. Annual mean absenteeism and presenteeism costs for patients in working age were US$61 and US$267, respectively.ConclusionsThe impact of T2DM on direct non-medical and indirect costs on diabetes is substantial. Direct non-medical and absenteeism costs were higher in patients with complications.

Download Full-text

Coverage of different health insurance programs and medical costs associated with chronic hepatitis C infection in mainland China: a cross-sectional survey in 20 provinces

Hepatology Medicine and Policy ◽

10.1186/s41124-016-0008-6 ◽

2016 ◽

Vol 1 (1) ◽

Cited By ~ 2

Author(s):

Hai-yang Zhou ◽

Shuang Liu ◽

Su-jun Zheng ◽

Xiao-xia Peng ◽

Yu Chen ◽

...

Keyword(s):

Chronic Hepatitis ◽

Health Insurance ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Mainland China ◽

Medical Costs ◽

Hepatitis C Infection ◽

Cross Sectional Survey ◽

Cross Sectional

Download Full-text

A cross-sectional survey of psychological distress in a Mexican sample during the second phase of the COVID-19 pandemic

10.31219/osf.io/wzqkh ◽

2020 ◽

Author(s):

Aldebarán Toledo-Fernández ◽

Diana Betancourt-Ocampo ◽

Héctor Romo-Parra ◽

Ernesto Reyes-Zamorano ◽

Alejandro González-González

Keyword(s):

Psychological Distress ◽

Online Survey ◽

Second Phase ◽

Cross Sectional Survey ◽

Baseline Measure ◽

Cross Sectional ◽

Impact Of Event Scale ◽

Event Scale ◽

Related Stress ◽

The Impact

The objectives of this study were to describe severity of psychological distress (event-related stress, anxiety, and depression) during the second stage of COVID-19 pandemic in Mexico, and to explore associations between the indicators of psychological distress, sociodemographic characteristics and specific concerns about COVID-19. This report serves as a baseline measure of a longitudinal project to evaluate progression of psychological distress across stages of the COVID-19 pandemic in Mexico. An online survey was conducted in the State of Mexico from April 8th -18th, 2020, in a sample of men and women who are beneficiaries of a welfare institution in the region. Variables were measured with the Impact of Event Scale-6, Patient Health Questionnaire-9, General Anxiety Disoder-7, and a questionnaire of concerns about COVID-19. A total of 5974 participants were analyzed. Moderate levels of psychological distress (with 23.6% of participants meeting significant event-related stress, but mild levels of depression and anxiety) were found, as well as high values in all concerns about COVID-19, especially regarding financial disruption, worsening of local security and concern of a family member becoming infected. These concerns associated mild-to-moderately with the indicators of psychological distress. Higher values of event-related distress were found in women, individuals with higher educational attainment and those with any current high-risk medical diagnosis, though the effect sizes were mild. Though psychological distress and concerns about COVID-19 have reached significant levels during the pandemic in Mexico, overall, they have not yet reached dysfunctional levels.

Download Full-text

Catastrophic costs of Tuberculosis care in a population with internal migrants in China

10.21203/rs.2.22858/v1 ◽

2020 ◽

Author(s):

Qi Jiang ◽

Liping Lu ◽

Jianjun Hong ◽

Xiaoping Jin ◽

Qian Gao ◽

...

Keyword(s):

Health Insurance ◽

Household Income ◽

Indirect Costs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Internal Migrant ◽

Total Household Income ◽

Before And After ◽

Internal Migrants ◽

Treatment Package

Abstract Background Although a free diagnosis and baseline treatment package was offered for tuberculosis (TB), hidden costs incurred by patients and their households could worsen their socio-economic and health status, particularly for migrants. We estimated the prevalence of catastrophic cost of TB patients and its associated factors in an urban population with internal migrants in China. Methods A cross-sectional survey was conducted to enroll culture-confirmed pulmonary TB patients in Songjiang district, Shanghai, between December 1, 2014, and December 31, 2015. Consenting participants completed a questionnaire, which collected direct and indirect costs before and after the diagnosis of TB. The catastrophic cost was defined as the annual expenses of TB care that exceeds 20% of total household income. We used logistic regression to identify factors associated with catastrophic costs. Results Overall, 248 drug-susceptible TB patients were enrolled, with 70% (174 of 248) of them being internal migrants. Migrant patients were significantly younger compared to resident patients. The total costs were 25,824 ($3,689) and 13,816 ($1,974) Chinese Yuan (RMB) for resident and internal migrant patients, respectively. The direct medical cost comprised about 70% of the total costs among both migrant and resident patients. Overall, 55% (132 of 248) of patients experienced high expenses ( > 10% of total household income), and 22% (55 of 248) experienced defined catastrophic costs. However, the reimbursement for TB care only reduced the prevalence of catastrophic costs to 20% (49 of 248). More than half of the internal migrants had no available health insurance (52%, 90 of 174). Hospitalizations, no available insurance, and older age contributed significantly to the occurrence of catastrophic costs. Conclusions. The catastrophic cost of TB service cannot be overlooked, despite the free policy. Migrants have difficulties benefiting from health insurance in urban cities. Interventions, including expanded medical financial assistance, are needed to secure universal TB care.

Download Full-text

Direct and indirect costs of families with a child with acute lymphoblastic leukaemia in an academic hospital in China: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2019-030511 ◽

2019 ◽

Vol 9 (7) ◽

pp. e030511

Author(s):

Yijiong Ren ◽

Xin Li

Keyword(s):

Acute Lymphoblastic Leukaemia ◽

Lymphoblastic Leukaemia ◽

Rural Families ◽

Indirect Costs ◽

Urban Families ◽

Medical Costs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Direct And Indirect Costs ◽

Three Phase

ObjectivesTo estimate the direct and indirect costs in families with a child with acute lymphoblastic leukaemia (ALL) in China.DesignA single-site, cross-sectional survey of primary caregiver of a child with ALL was performed.Setting and participantsWe analysed the total costs incurred on the completion of the first three-phase treatment (induction, consolidation and intensification), which requires intensive hospitalisation. Eligible patients were (1) diagnosed with ALL between 2010 and 2012 at Shanghai Children’s Medical Center (SCMC), (2) aged 0–14 years at diagnosis and (3) completed the first three-phase treatment at SCMC. The data were collected between October 2014 and December 2014.Outcome measuresWe decomposed the total costs into three categories: (1) direct medical costs, which were further divided into outpatient and inpatient costs; (2) direct non-medical costs, which referred to expenses incurred in relation to the illness; and (3) indirect costs due to productivity loss.ResultsA total of 161 patients were included in the study. Direct medical costs accounted for about 51.7% of the overall costs, and the rest of 48.3% of the total costs were attributed to direct non-medical costs and indirect costs. Regarding families with different household registration type (rural vs urban), the total costs were significantly different between the two groups (US$36 125 vs US$25 593; p=0.021). Specifically, urban families incurred significantly larger indirect costs than rural families (US$12 343 vs US$4157; p=0.018). Although the direct non-medical costs were not significantly different, urban families spent more money on hygiene cleaning products and auxiliary treatment equipment (p=0.041) and gifts and treats (p=0.034) than rural families.ConclusionsThe financial burden faced by the Chinese families with a child with ALL was tremendous, and the distributions of costs among the three categories were different between urban and rural families.

Download Full-text

Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

10.2196/preprints.24776 ◽

2020 ◽

Author(s):

Khanh Ngoc Cong Duong ◽

Tien Nguyen Le Bao ◽

Phuong Thi Lan Nguyen ◽

Thanh Vo Van ◽

Toi Phung Lam ◽

...

Keyword(s):

Psychological Distress ◽

General Population ◽

Psychological Health ◽

Online Survey ◽

Survey Study ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Event Scale ◽

The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

Download Full-text

COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116076 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6076

Author(s):

Hasan S. Alamri ◽

Wesam F. Mousa ◽

Abdullah Algarni ◽

Shehata F. Megahid ◽

Ali Al Bshabshe ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care Workers ◽

Psychological Impact ◽

Psychological Outcomes ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Care Workers ◽

The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

Download Full-text

Are e-learning Webinars the future of medical education? An exploratory study of a disruptive innovation in the COVID-19 era

Cardiology in the Young ◽

10.1017/s1047951120004503 ◽

2020 ◽

pp. 1-10

Author(s):

Colin J. McMahon ◽

Justin T. Tretter ◽

Theresa Faulkner ◽

R. Krishna Kumar ◽

Andrew N. Redington ◽

...

Keyword(s):

Deep Learning ◽

Carbon Footprint ◽

Quantitative Research ◽

Survey Design ◽

Hybrid Approach ◽

Disruptive Innovation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

E Learning ◽

The Impact

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

Download Full-text