scholarly journals Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Vahid Alipour ◽  
Hamed Zandian ◽  
Vahid Yazdi-Feyzabadi ◽  
Leili Avesta ◽  
Telma Zahirian Moghadam

Abstract Background Different countries have set different policies to control and decrease the costs of cardiovascular diseases (CVDs). Iran was aiming to reduce the economic burden of different disease by a recent reform from named as health transformation plan (HTP). This study aimed to examine the economic burden of CVDs before and after of HTP. Methods This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, the central bank of Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials (IRR). Results Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after (62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p = 0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2 to 36.7%. All hospitalization costs, except patients’ OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion Economic burden of CVDs increased in the north-west of Iran after the HTP due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, more detailed studies should be carried out on the reasons for the significant increase in CVDs costs in the region.

2020 ◽  
Author(s):  
Vahid Alipour ◽  
Hamed Zandian ◽  
Vahid Yazdi-Feyzabadi ◽  
Leili Avesta ◽  
Telma Zahirian Moghadam

Abstract Background Different countries have set different policies to control and decrease the costs of Cardiovascular Diseases(CVDs). Iran aiming reducing the economic burden of different disease by a recent reform from named as health transformation plan(HTP). This study aimed to examine economic burden of CVDs before and after of HTP, Methods This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran's Ministry of Cooperatives, Labor, and Social Welfare, central bank of the Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials(IRR). Results Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after(62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p=0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2% to 36.7%. All hospitalization costs, except patients' OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion The economic burden of CVDs after the HTP increased in the north-west of Iran due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, studies that are more detailed should be carried out on the reasons for the significant increase in CVDs costs in the region.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gustavo Silva-Paredes ◽  
Rosa M. Urbanos-Garrido ◽  
Miguel Inca-Martinez ◽  
Danielle Rabinowitz ◽  
Mario R. Cornejo-Olivas

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.


Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 988
Author(s):  
Ahmed Alghamdi ◽  
Eman Algarni ◽  
Bander Balkhi ◽  
Abdulaziz Altowaijri ◽  
Abdulaziz Alhossan

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Cebisile Ngcamphalala ◽  
Ellinor Ostensson ◽  
Mbuzeleni Hlongwa ◽  
Themba G. Ginindza

Abstract Background Despite the well-documented information on cancer prevention and management, among noncommunicable diseases (NCDs), globally, cancer continues to be the second leading cause of morbidity and mortality with devastating economic consequences. The burden is disproportionately more among developing countries and the extent of evidence available on the economic consequences (direct and indirect costs) of cancer remains unknown in low-income countries particularly in the sub-Saharan region. Understanding the costs of illness is important to inform decision-making on setting up health care policies and informing economic evaluation of interventions. This study aims to map evidence on the distribution of the economic burden (direct and indirect costs) associated with prevention, diagnosis, and treatment of three predominant cancers: prostate, cervix, and female breast in the sub-Saharan Africa. Methods This scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR), and will be conducted following Arksey and O’Malley’s framework. We will search PubMed/MEDLINE, Web of Science, CINHAL (via EBSCOhost platform), Science Direct, Cochrane Database of Systematic Reviews, Africa-Wide Information, Google Scholar, and WHO Library. We will perform hand-searching of the reference lists of included studies and other relevant documents. Two reviewers will independently screen all citations, full-text articles, and abstract data. We will include primary studies from all study designs reporting costs associated with prevention, diagnosis and treatment of prostate, cervical, and breast cancers in the sub-Saharan region. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., thematic analysis) methods. A narrative summary of findings will be presented. Discussion This review will map the extent of information available on the economic burden (direct and indirect costs) of prostate, cervical, and breast cancers in the sub-Saharan region. Further guidance for future research in the subject area will be discussed. Systematic review registration Open Science Framework


Author(s):  
W.N. Minnaar ◽  
R.C. Krecek

Information on the socioeconomic aspects and the health status of dogs in 2 resource-limited communities in the North West and Gauteng provinces of South Africa was gathered using semi-structured interviews and a standardised questionnaire. The dogs were examined clinically to determine their health status, and their body condition and age were scored. Most of the dogs (93 % in Jericho and 90 % in Zuurbekom) were infected with hookworm, which poses a threat to animal and human health in the 2 study areas. Many dogs were also being given a protein-deficient diet, which together with hookworm parasites would impact considerably on the dog's health. Dogs were mainly kept for security reasons. The need indicated to be most important by the residents of the 2 commnities was a lack of available and affordable veterinary services.


Author(s):  
Mojtaba SALIMI ◽  
Abedin SAGHAFIPOUR ◽  
Hadi HAMIDI PARSA ◽  
Majid KHOSRAVI

Background: The head louse infestation is a public health issue in the world especially, affecting most people who live in camps, school-aged children and their families. Head lice treatment has economic ramifications that often under calculated. The aim of this study was evaluation of economic burden associated with head louse infestation in Iran. Methods: In a cross-sectional study, 500,002 infestations were diagnosed among suspected head lice infested people who referred to health care system in all provinces of Iran during 2017. Direct and indirect costs related to paid by patients and government systems were extracted by referring to accounting documents and interviews with patients and experts and were recorded in researcher-made forms. Microsoft Excel 2010 software was used for economic burden calculation. Results: The incidence rate of head lice infestation in Iran was 500,002/79,926,270 (625.5 per 100,000 populations). Economic burden of head lice in the country was calculated at 5,790,143$. Direct and indirect costs, governmental cost, out of pocket and total costs of head lice were included 3.14$, 2.84$, 5.98$, 5.60$ and 11.58$ per case respectively. Conclusion: The direct and indirect costs associated with treatment of infestations were relatively high. Therefore, the creation of medical facilities such as availability of diagnostic and treatment strategies can be effective in the control of infestation. The adoption of infestation prevention methods, such as health education to people at risk of infestation, reduces the incidence of head lice and imposition of related treatment costs on governmental health care system and head lice cases.


2020 ◽  
Author(s):  
Mohsen Ghaffari Darab ◽  
Khosro Keshavarz ◽  
Elnaz Sadeghi ◽  
Javad Shahmohamadi ◽  
Zahra Kavosi

Abstract This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and 59,203,409 Rials ($ 3,755) per person, a significant part of which (41 %) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510. (The second to which were the costs of medicines and medical consumables (28 %). The mean indirect costs including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated 129,870,974 Rials ($ 11634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rial equal to $ 1,439,083,784.Conclusion: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S158
Author(s):  
Chirag Shroff

AimsHealth Education England launched a new system for study leave and study budget on 1st April 2018, in response to trainees' concerns regarding the previous system. According to this, Health Education England would manage the study leave budget through its local offices, making the process of accessing study ‘more transparent, equitable and streamlined' for all trainees. At the RAP Oversight Committee meeting of the North West Deanery in 2019, trainees' uncertainties over the process was discussed by the local reps. It was aimed that there was a need to gather information on trainees' needs and understanding of local processes in place by the deanery to access study leave and study budgetMethodA cross sectional survey was sent out to all the trainees by the Core Trainees year 1 RAP rep. A total of 6 relevant questions were designed and sent out to the trainees, allowing them 2 weeks’ time to respond. There were a total of 66 trainees who were sent the survey. The guidance mentioned in the 2016 Gold guide was used for reference to ensure the questions are relevant.ResultOf the total of 66 trainees who were sent the survey, there were 48 respondents. The results indicated that all 48 responders preferred study budget and leave process explained at induction. 47 of 48 respnders sought access to their study budget, 46 of 48 responders sought use of budget for external course and exam fees fudning, 27 of the 48 responders struggled to get study leave and 27 of 48 responders felt the current leave process was not satisfactory with 14 opining that there was scope for improvemement.ConclusionThe responses were collated by the trainee rep as a PowerPoint presentation containing graphical representation of trainees’ views regarding their study leaves and budget access. The survey results were made aware to the local board at the subsequent RAP Oversight Committee meeting to seek response and new guidance. There is a new system in place for study leave and study budgets, overseen by Health Education England. Overall, the survery attempted to understand and collate trainees' wants and needs, in effect improving trainee experiences.


2019 ◽  
Vol 36 (1) ◽  
pp. 69-78
Author(s):  
Neda Safaeifard ◽  
Hossein Namdar Areshtanab ◽  
Fariborz Roshangar ◽  
Hossein Ebrahim ◽  
Hossein Karimi Moonaghi ◽  
...  

Summary Generally, progress, productivity and success of any organization depends on the skills and knowledge of their manpower. Thus, better and more accurate training programs in organizations will lead to their growth and efficiency will be eventually achieved. Due to the many advances in the field of medicine, nurses are the backbone of activities in organizations of medical sciences and patient’s affairs. For this purpose, in-service training courses for employees are the most important courses in nursing. This study was conducted at the University of Medical Sciences (Tabriz-Iran) aiming to determine the preferred learning styles of nurses in in-service training courses. In this cross-sectional study, all nurses working in medical and educational centers in a university in the North West of Iran were randomly selected. To collect data, a two-part questionnaire of Kolb’s demographic and social information was used. Data was analyzed by using descriptive and analytical statistics SPSS version 17 software. A total of 470 nurses with an average age of 36.46 ± 5.77 were studied. There was a significant correlation between preferred learning styles of nurses with nursing position, employment status, and income level. There was no a significant statistical relationship between the preferred learning style of nurses with age, work experience and experience in the center. The present study shows that the highest percentage of Kolb’s learning style is related to the preferential converging learning style (57.8%). This study aimed to determine the preferred learning styles of nurse’s in-service training courses in Tabriz University of Medical Sciences. The results of the study showed that converging and assimilating styles were the preferred learning ones among the majority of nurses; these styles are effective and interpreted according to their profession requiring a lot of information and knowledge. Due to the dominance of converging learning style among nurses, it is recommended to use appropriate teaching methods tailored to the style including the use of diagrams, presentations, lectures and self-learning with enjoyable materials.


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