scholarly journals Association between livelihood capital and catastrophic health expenditure among patients with critical illness: a cross-sectional study in rural Shandong, China

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051234
Author(s):  
Xin Che ◽  
Jiajia Li ◽  
Wenhao Fu ◽  
Feng Fang
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Health Expenditure ◽  
Natural Capital ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Out Of Pocket Payments

ObjectiveThe objective of this study is to examine the association between livelihood capital and catastrophic health expenditure (CHE).DesignBetween July and August 2019, a cross-sectional study was conducted in critically ill patients.SettingShandong, China.Participants1041 households with critically ill patients from 77 villages.Primary and secondary outcome measuresWe defined expenditure as being catastrophic if a household’s out-of-pocket payments were greater than or equal to 40% of their capacity to pay. Using the sustainable livelihoods framework, this study explored the associations between CHE and the various forms of livelihood capital—inclusive of human capital, natural capital, physical capital, financial capital and social capital. χ2 tests, t-tests, Wilcoxon tests and binary logistic regression analysis were performed to examine these associations.ResultsThe incidence of CHE among households with critically ill patients was 76.37% in this study. Better livelihood capital was significantly associated with lower incidence of CHE. After controlling for confounding factors, households with healthier patients (OR 0.47, 95% CI 0.23 to 0.96), more real estate ownership (OR 0.35, 95% CI 0.19 to 0.67) and better economic status (OR 0.33, 95% CI 0.18 to 0.62) were associated with a reduction in the occurrence of CHE.ConclusionsLivelihood capital was significantly associated with CHE in rural families with critically ill patients. This association suggests that, in addition to providing health insurance to the critically ill, more attention should be paid to their ability to create and preserve livelihood capital.

scholarly journals VALUE OF CLINICAL PULMONARY INFECTION SCORE IN CRITICALLY ILL PATIENTS: BETWEEN THE USE OF CHLORHEXIDINE AND PIPER BETLE LINN MOUTHWASH

2018 ◽  
Vol 4 (1) ◽  
pp. 76-82
Author(s):  
Irfany Nurul Hamid ◽  
Rr Sri Endang Pujiastuti ◽  
Dwi Ari Widigdo ◽  
Djenta Saha
Keyword(s):  
Treatment Group ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pulmonary Infection ◽  
Cross Sectional Study ◽  
Piper Betle ◽  
Ventilator Associated Pneumonia ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

Background: One of the complications of ventilator use in patients in Intensive Care Unit (ICU) is Ventilator-Associated Pneumonia (VAP). Oral hygienes is one of the methods to prevent VAP.Objective: The objective of this study was to compare the value of clinical infection score (CPIS) in critically ill patients after given oral hygiene using chlorhexidine and Piper betle Linn mouthwash.Methods: This was an observational study with cross-sectional study design, which consisted of two intervention groups. Thirty respondents were selected using total sampling, with 15 respondents randomly assigned in each group. Independent t-test was used for data analysis.Results: Findings showed that  the mean of CPIS in the Piper betle Linn group was 3.80 and the mean of CPIS in the chlorhexidine group was 4.07.Conclusion: CPIS in the treatment group using Piper betle Linn mouthwash was lower than the mean of CPIS in the treatment group using clorhexidine. 

scholarly journals Catastrophic Health Expenditure, Distress Financing and Impoverishment due to Out-of-Pocket Expenses for Healthcare among Patients with Chronic Liver Disease: A Cross-sectional Study among Hospitalized Patients in Bangladesh

2021 ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
Mahmudul Hasan
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Health Expenditure ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Hospitalized Patients ◽  
Chronic Liver ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Financing

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p < 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.

scholarly journals Extent and determinants of catastrophic health expenditure for tuberculosis care in Chongqing municipality, China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026638 ◽  
Author(s):  
Weixia Duan ◽  
Wen Zhang ◽  
Chengguo Wu ◽  
Qingya Wang ◽  
Ya Yu ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Expenditure ◽  
Protective Factor ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Patient Delay ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chongqing Municipality

ObjectiveTo investigate the extent and associations of patient/diagnostic delay and other potential factors with catastrophic health expenditure (CHE) for tuberculosis (TB) care in Chongqing municipality, China.DesignA cross-sectional study.SettingFour counties of Chongqing municipality, China.ParticipantsA total of 1199 patients with active pulmonary TB beyond 16 years and without mental disorders were consecutively recruited in the four counties’ designated TB medical institutions.Outcome measuresThe incidence and intensity of CHE for TB care were described. The association between patients’ ‘sociodemographic and clinical characteristics such as patient delay, diagnostic delay, forms of TB, health insurance status and hospitalisation and CHE were analysed using univariate and multivariate logistic regression.ResultsThe incidence of CHE was 52.8% and out-of-pocket (OOP) payments were 93% of the total costs for TB care. Compared with patients without delay, the incidence and intensity of CHE were higher in patients who had patient delay or diagnostic delay. Patients who experienced patient delay or diagnostic delay, who was a male, elderly (≥60 years), an inhabitant, a peasant, divorced/widow, the New Cooperative Medical Scheme membership had greater risks of incurring CHE for TB care. Having a higher educational level appeared to be a protective factor. However, hospitalisation was not associated with CHE after controlling for other variables.ConclusionThe incidence and intensity of CHE for TB care are high, which provides baseline data about catastrophic costs that TB-related households faced in Chongqing of China. Variety of determinants of CHE implicate that it is essential to take effective measures to promote early seeking care and early diagnosis, improve the actual reimbursement rates of health insurance, especially for outpatients, and need more fine-tuned interventions such as precise poverty alleviation to reduce catastrophic costs of the vulnerable population.

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