scholarly journals Cost analysis of informal care: estimates from a national cross-sectional survey in Sweden

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Björn Ekman ◽  
Kevin McKee ◽  
Joana Vicente ◽  
Lennart Magnusson ◽  
Elizabeth Hanson
Keyword(s):  
Informal Care ◽  
Adult Population ◽  
Informal Caregivers ◽  
Indirect Costs ◽  
Direct Costs ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Income Loss ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Abstract Background Over the past decades, informal care has increased in most OECD-countries. Informal care is costly to caregivers and to society in the form of lost income and direct costs of providing care. Existing evidence suggests that providing informal care affects caregivers’ overall health. However, estimates of the social costs of informal care based on national data on individuals are currently scarce. Objective This study contributes to the existing evidence on the costs of informal care by estimating the direct and indirect costs to caregivers using a purposive national household survey from Sweden. Methods Adopting a bottom-up, prevalence approach, the direct and indirect costs are estimated using the survey data and the value of working time and leisure time from existing sources. Results The results suggest that around 15% of the adult population of Sweden provide informal care and that such care costs around SEK 152 billion per year (around 3% of GDP; USD 16,3 billion; EUR 14,5 billion), or SEK 128000 per caregiver. Around 55% of costs are in the form of income loss to caregivers. The largest cost items are reduced work hours and direct costs of providing informal care. Replacing informal caregivers with professional care providers would be costly at around SEK 193,6 billion per year. Conclusions Findings indicate that, even in a country with a relatively generous welfare system, significant resources are allocated toward providing informal care. The costing analysis suggests that effective support initiatives to ease the burden of informal caregivers may be cost-effective.

scholarly journals Economic burden of Huntington’s disease in Peru

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gustavo Silva-Paredes ◽  
Rosa M. Urbanos-Garrido ◽  
Miguel Inca-Martinez ◽  
Danielle Rabinowitz ◽  
Mario R. Cornejo-Olivas
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Economic Burden ◽  
Annual Cost ◽  
Healthcare Costs ◽  
Neurodegenerative Disorder ◽  
Indirect Costs ◽  
Direct Costs ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Abstract Background Huntington’s disease (HD) is a devastating and fatal neurodegenerative disorder that leads to progressive disability, and over time to total dependence. The economic impact of HD on patients living in developing countries like Peru is still unknown. This study aims to estimate the economic burden by estimating direct and indirect costs of Huntington’s disease in Peru, as well as the proportion of direct costs borne by patients and their families. Methods Disease-cost cross-sectional study where 97 participants and their primary caregivers were interviewed using a common questionnaire. Prevalence and human capital approaches were used to estimate direct and indirect costs, respectively. Results The average annual cost of HD reached USD 8120 per patient in 2015. Direct non-healthcare costs represented 78.3% of total cost, indirect costs 14.4% and direct healthcare costs the remaining 7.3%. The mean cost of HD increased with the degree of patient dependency: from USD 6572 for Barthel 4 & 5 (slight dependency and total independency, respectively) to USD 23,251 for Barthel 1 (total dependency). Direct costs were primarily financed by patients and their families. Conclusions The estimated annual cost of HD for Peruvian society reached USD 1.2 million in 2015. The cost impact of HD on patients and their families is very high, becoming catastrophic for most dependent patients, and thus making it essential to prioritize full coverage by the State.

scholarly journals 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 ◽  
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.

scholarly journals COVID-19 Vaccine Uptake among U.S. Child Care Providers

2021 ◽  
Author(s):  
Kavin Patel ◽  
Amyn A. Malik ◽  
Aiden Lee ◽  
Madeline Klotz ◽  
John Eric Humphries ◽  
...  
Keyword(s):  
Public Health ◽  
Child Care ◽  
Adult Population ◽  
Vaccine Uptake ◽  
Child Care Providers ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Cross Sectional ◽  
Home Based

Objectives: Ensuring a high COVID-19 vaccine uptake among U.S. child care providers is crucial to mitigating the public health implications of child-to-staff and staff-to-child transmission of SARS-CoV-2; however, the vaccination rate among this group is unknown. Methods: To characterize the vaccine uptake among U.S. child care providers, we conducted a cross-sectional survey of the child care workforce. Providers were identified through various national databases and state registries. A link to the survey was sent via email between May 26 and June 23, 2021. Out of 44,771 potential respondents, 21,663 responded (48.4%). Results: Overall COVID-19 vaccine uptake among U.S. child care providers (78.1%, 95% CI [77.3% to 78.9%]) was higher than that of the U.S. adult population (65%). Vaccination rates varied from 53.5% to 89.4% between states. Vaccine uptake differed significantly (p < .01) based on respondent age (70.0% for ages 25-34, 91.5% for ages 75-84), race (70.0% for Black or African Americans, 92.5% for Asian-Americans), annual household income (70.7% for <$35,000, 85.0% for>$75,000), and childcare setting (72.9% for home-based, 79.7% for center- based). Conclusions: COVID-19 vaccine uptake among U.S. child care providers was higher than that of the general U.S. adult population. Those who were younger, lower income, Black or African American, resided in states either in the Mountain West or the South, and/or worked in home- based childcare programs reported the lowest rates of vaccination; state public health leaders and lawmakers should prioritize these subgroups for placement on the policy agenda to realize the largest gains in vaccine uptake among providers.

scholarly journals Estimation of direct and indirect costs of occupational injuries: A case study in one of the refining industries in Iran in 2015

2020 ◽  
Author(s):  
A Mohamadinejad ◽  
SB Mortazavi ◽  
A Jonidi Jafari ◽  
A Mofidi
Keyword(s):  
Occupational Injuries ◽  
Indirect Costs ◽  
Cross Sectional Study ◽  
Direct Costs ◽  
Production Costs ◽  
Cross Sectional ◽  
Direct And Indirect Costs ◽  
Productivity Losses ◽  
The Status ◽  
Health Related

Introduction: Occupational injuries can impose a significant cost to the country’s economy. In developing countries, it is usually difficult to get access to occupational injuries data mainly because the lack of appropriate reporting and recording system, and in these countries, making it difficult to accurately estimate the costs of these injuries. The purpose of this study is to estimate the  direct and indirect costs of occupational injuries in one of the Iranian refining industries. Materials and Methods: This cross-sectional study was performed on all occupational injuries, including outpatient injuries to deaths in 2015. Data was collected based on a bottom-up approach, by using the recorded documents and a researcher-made questionnaire. Lastly the direct and indirect costs for different stockholders, including workers and their families, industry and society as a whole, were calculated. Investigated direct costs of occupational injuries included The healthcare costs, out of pocket cost and informal caregiving and Indirect costs included productivity losses, reorganization and investigation costs and home production costs. Results:  It is estimated that occupational injuries impose 103,385 million Rials to the society over a year. Investigated direct costs of occupational injuries imposed 14,152 million Rials (48 million Rials per case). Indirect costs imposed 89,232 million Rials to the society (308 million Rials per case). Also the average healthcare cost per case for fatal injuries is estimate 125 million, for serious injuries 12 million Rials and for outpatient injuries 780,000 Rials Conclusion: According to the results of the study, occupational injuries annually bring significant economic costs to the industry, workers and their families which a significant portion of these costs are indirect costs. These results indicates the status and importance of occupational injuries and therefore can be used by decision-makers and planners in occupational health-related issues.

scholarly journals Direct and Indirect Costs of Obesity in Brazil: A Systematic Review

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1623-1623
Author(s):  
Bianca Curi Braga ◽  
Camila Ricardo ◽  
Vitor Carvalho ◽  
Ana Clara Duran
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Indirect Costs ◽  
Well Being ◽  
Direct Costs ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Cross Sectional ◽  
Direct And Indirect Costs ◽  
Lower Productivity

Abstract Objectives Obesity burdens families, governments, and companies with a variety of direct costs for healthcare, and also indirect costs in lower productivity and well-being. To measure these costs in a middle-income country with rapidly rising obesity rates, we conducted a systematic review of the literature on the direct and indirect costs of obesity in Brazil. Methods We searched for English and Portuguese language publications from 2004 to 2017 in EconLit, SciELO, NBER, PubMed, and Scopus. We included all studies that calculated the direct and indirect costs of obesity, except those that exclusively measured costs associated with bariatric surgery. No studies included were based on interventions. When studies calculated costs of obesity for a subset of the population, we extrapolated to the whole of Brazil, and all values were adjusted for inflation and expressed in 2017 prices. Results The initial search identified 811 abstracts, of which eight publications met our criteria and were included. Seven of them have direct costs, while only one assessed indirect costs of obesity. Total costs of obesity in Brazil ranged from USD 133.8 million to USD 6.3 billion per year. This wide variance was driven by the difference in methods employed as well as diseases considered. Medication and out-of-pocket expenses were higher in households with obese individuals. The studies included were assessed according to the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Institute of Health, complying from 40% to 60% of the applicable criteria. All studies included only a fraction of known costs. Most included only data from public health care facilities, omitting expenditures at private clinics and pharmacies, and they used different comorbidities and criteria for measurement. Studies are also cross-sectional, and cannot determine causality. Conclusions Evidence of the cost of obesity in Brazil is limited. The wide variance in methods used to calculate direct costs in the country restricts our ability to summarize the available evidence. However, all studies resulted in high costs of obesity. Studies that measure the indirect costs of obesity in Brazil are needed. Funding Sources Bloomberg Philanthropies through a sub-award agreement (5,104,695) between the University of North Carolina at Chapel Hill and Fundação Faculdade de Medicina, Brazil.

scholarly journals Factors associated with informal caregiving and its effects on health, work, and social activities of adult informal caregivers in Malaysia: findings from the National Health and Morbidity Survey 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuke-Lin Kong ◽  
Jailani Anis-Syakira ◽  
Suhana Jawahir ◽  
Yeung R’ong Tan ◽  
Noor Hasidah Ab Rahman ◽  
...  
Keyword(s):  
Informal Care ◽  
National Health ◽  
Adult Population ◽  
Informal Caregivers ◽  
Well Being ◽  
Informal Caregiving ◽  
Social Activities ◽  
Health Work ◽  
Cross Sectional Survey ◽  
Factors Associated

Abstract Background The increase in the elderly population, chronic and degenerative diseases, as well as accidents at work and on the road in Malaysia would result in an increased demand for informal care. This paper aimed to determine the associated factors of informal caregiving and its effects on health, work and social activities of adult informal caregivers in Malaysia. Methods The data from the 2019 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey with a two-stage stratified random sampling design, was used in this research. The study included respondents who were 18 years and older (n = 11,674). Data were obtained via face-to-face interviews using validated questionnaires. Descriptive and complex sample logistic regression analyses were employed as appropriate. Results 5.7% of the adult population were informal caregivers. Provision of informal care were significantly associated with the female sex (OR = 1.52, 95% CI [1.21, 1.92]), those aged 36–59 years (OR = 1.61, 95% CI [1.15, 2.25]), and those who reported illness in the past 2 weeks (OR = 1.79, 95% CI [1.38, 2.33]). The risk of having their health affected were associated with female caregivers (OR = 3.63, 95% CI [1.73, 7.61]), those who received training (OR = 2.10, 95% CI [1.10, 4.00]) and those who provided care for 2 years or more (OR = 1.91, 95% CI [1.08, 3.37]). The factors associated with the effects on work were ethnicity, received training and had no assistance to provide the care. In terms of effect on social activities, female caregivers (OR = 1.96, 95% CI [1.04, 3.69]) and caregivers who received training were more likely (OR = 2.19, 95% CI [1.22, 3.93]) to have their social activities affected. Conclusion Our study revealed that sex, age, and self-reported illness were factors associated with being an informal caregiver in Malaysia. Informal caregivers faced effects on their health, work, and social activities which may be detrimental to their well-being. This understanding is crucial for planning support for caregivers.

scholarly journals Oral Health Status, Knowledge, and Behaviours of People with Diabetes in Sydney, Australia

2021 ◽  
Vol 18 (7) ◽  
pp. 3464
Author(s):  
Prakash Poudel ◽  
Rhonda Griffiths ◽  
Amit Arora ◽  
Vincent W. Wong ◽  
Jeff R. Flack ◽  
...  
Keyword(s):  
Health Status ◽  
Oral Health ◽  
Diabetes Care ◽  
Health Knowledge ◽  
Oral Health Status ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Oral Health Knowledge ◽  
Sydney Australia

This study assessed self-reported oral health status, knowledge, and behaviours of people living with diabetes along with barriers and facilitators in accessing dental care. A cross sectional survey of 260 patients from four public diabetes clinics in Sydney, Australia was undertaken using a 35-item questionnaire. Data were analysed using SPSS software with descriptive and logistic regression analyses. More than half (53.1%) of respondents reported having dental problems which negatively impacted their related quality of life. Less than half (45%) had adequate oral health knowledge. Only 10.8% reported receiving any oral health information in diabetes care settings, which had higher odds of demonstrating adequate oral health knowledge (AOR, 2.60; 95% CI, 1.06–6.34). Similarly, 62.7% reported seeing a dentist in the last 12 months. Having private health insurance (AOR, 3.70; 95% CI, 1.85–7.40) had higher odds of seeing a dentist in the past 12 months. Dental costs were a major contributor to avoiding or delaying dental visit. Patients living with diabetes have unmet oral health needs particularly around the awareness of its importance and access to affordable dental services. Diabetes care providers can play a crucial role in this area by promoting oral health to their patients.

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.

scholarly journals POS0530 HOW DOES MULTIMORBIDITY IMPACT ON THE DIRECT AND INDIRECT COSTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 498.3-499
Author(s):  
P. H. Hsieh ◽  
C. Geue ◽  
O. Wu ◽  
E. McIntosh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Employment Status ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Information Service ◽  
Indirect Costs ◽  
Direct Costs ◽  
Direct And Indirect Costs ◽  
The Impact

Background:Comorbidities are prevalent in patients with rheumatoid arthritis (RA) and associated with worse outcomes as well as higher economic burden. Little is known about the impact of multimorbidity on the direct and indirect costs of RA. Evidence of the incremental scale of these multimorbidity costs will usefully inform RA interventions and policies.Objectives:The aim of this study was to describe how multimorbidity impacts on the cost-of-illness, including direct and indirect costs, in patients with RA.Methods:The Scottish Early Rheumatoid Arthritis (SERA) is a registry of patients newly presenting with RA since 2011. It contains data on patient characteristics, clinical outcomes, health-related quality of life, and employment status data. These data were linked to routinely recorded hospital admissions and primary care prescribing data. Direct costs were estimated by applying relevant unit costs to healthcare resource use quantities. Indirect cost estimates were obtained from information on employment status and hospital admissions, valued by age and sex specific wages. Two-part models (probit followed by generalized linear model) were used to estimate direct and indirect costs, adjusting for age, gender, and functional disability. The Charlson Comorbidity Index (CCI) score was calculated using patient ICD-10 diagnoses from hospital records. The number of comorbidities was categorized into “RA alone”, “single comorbidity” and “multimorbidity (>1 comorbidity)”.Results:Data were available for 1,150 patients, 65.7% were female and a mean age of 57.5±14 years. The majority of patients only had RA (54.1%), followed by a single comorbidity (23.4%) and multimorbidity (22.5%). Annual total costs were significantly higher for patients with multimorbidity (£6,669 95% CI £4,871-£8,466; OR 11.3 95% CI 8.14-15.87) and for patients with a single comorbidity (£2,075 95% CI £1,559-£2,591; OR 3.52 95% CI 2.61-4.79), when compared with RA alone (£590). The excess costs were mainly driven by direct costs (£6,281 versus £1,875 versus £556). Although the difference in indirect costs between patients with multimorbidity and a single comorbidity were not statistically significant (£1,218 versus £914, p=0.11), patients with multimorbidity were associated with significantly higher costs than those with RA only (£594, p<0.01).Conclusion:The presence of comorbidity contributes significant excess to both direct and indirect costs among RA patients. In particular, patients with multimorbidity incurred substantially higher direct costs than those with a single comorbidity or RA only.Acknowledgements:The study analysed the data from the Scottish Early Rheumatoid Arthritis (SERA) study with a linkage to routinely recorded health data from Information Service Division, National Service Scotland. We would like to thank all the patients, clinical and nursing colleagues who have contributed their time and support to the study, the SERA steering committee for the approval, and Allen Tervit from the Robertson Centre for Biostatistics, University of Glasgow for the timely technical supports.Disclosure of Interests:Ping-Hsuan Hsieh: None declared, Claudia Geue: None declared, Olivia Wu Consultant of: OW has received consultancy fees from Bayer, Lupin and Takeda outside the submitted work., Emma McIntosh: None declared

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Planned Behaviour ◽  
Sexual History ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Planned Behaviour

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

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