scholarly journals Out-of-pocket payments and catastrophic expenditures due to traffic injuries in Ouagadougou, Burkina Faso

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laurène Petitfour ◽  
Emmanuel Bonnet ◽  
Isadora Mathevet ◽  
Aude Nikiema ◽  
Valéry Ridde

Abstract Objective To estimate the out-of-pocket expenditures linked to Road Traffic Injuries in Ouagadougou, Burkina Faso, as well as the prevalence of catastrophic expenditures among those out-of-pocket payments, and to identify the socio-economic determinants of catastrophic expenditures due to Road Traffic Injuries. Methods We surveyed every admission at the only trauma unit of Ouagadougou between January and July 2015 at the time of their admission, 7 days and 30 days later. We estimate a total amount of out-of-pocket expenditures paid by each patient. We considered an expense as catastrophic when it represented 10% at least of the annual global consumption of the patient’s household. We used linear models to determine if socio-economic characteristics were associated to a greater or smaller ratio between out-of-pocket payment and global annual consumption. Findings We surveyed 1323 Road injury victims three times (admission, Days 7 and 30). They paid in average 46,547 FCFA (83.64 US dollars) for their care, which represent a catastrophic expenditure for 19% of them. Less than 5% of the sample was covered by a health insurance scheme. Household economic status is found to be the first determinant of catastrophic health expenditure occurrence, exhibiting a significant and negative on the ratio between road injury expenditures and global consumption. Conclusion Our findings highlight the importance of developing health insurance schemes to protect poor households from the economic burden of road traffic injuries and improve equity in front of health shocks.

Author(s):  
Razieh Ahmadi ◽  
Milad Shafiei ◽  
Hosein Ameri ◽  
Roohollah Askari ◽  
Hossein Fallahzadeh

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods: Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results: The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.


2020 ◽  
Vol 44 (4) ◽  
pp. 191-198
Author(s):  
Jelena Kovačević ◽  
Hrvoje Palenkić ◽  
Ivan Miškulin ◽  
Oliver Pavlović ◽  
Marinela Kristić ◽  
...  

Road traffic injuries cause considerable losses to individuals, their families, and to nations as a whole. Factors related to road traffic injuries and to the severity of such injuries have not been fully elucidated or evaluated. The aim of this study was to explore factors related to road traffic injuries and their severity in cohort of 200 road traffic accident (RTA) survivors from Eastern Croatia. Sustaining injury was associated with rural residence (p=0.032), lower education level (p=0.001), unemployment (p=0.001), being single (p=0.014), under average self-assessed economic status (p=0.001), alcohol abstinence (p=0.018), use of medications (p=0.031), self-assessed life-threat (p<0.001), pain after the RTA (p<0.001), hospitalization after the RTA (p<0.001), hospitalization duration (p<0.001), surgery (p=0.048), rehabilitation following the RTA (p=0.001) and PTSD symptoms (p=0.001). Injury severity was associated with lower education level (p=0.013), unemployment (p=0.004), being single (p=0.017), under average self-assessed economic status (p<0.001), alcohol abstinence (p=0.042), use of medications (p=0.014), self-assessed life-threat (p<0.001), pain after the RTA (p<0.001), being a pedestrian or a cyclist (p=0.011), hospitalization after the RTA (p<0.001), hospitalization duration (p<0.001), surgery (p<0.001), rehabilitation following the RTA (p=0.001), depression (p<0.001) and PTSD symptoms (p<0.001). In order to more adequately prevent road traffic injuries knowledge about factors associated with such injuries and their severity should be base for the creation of specific prevention programs at regional and national level.


2021 ◽  
Vol 21 (2) ◽  
pp. 817-825
Author(s):  
Robert Moshiro ◽  
Francis F Furia ◽  
Augustine Massawe ◽  
Elia John Mmbaga

Background: Injuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania. Methods: This case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were col- lected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively. Results: A total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3-2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0-2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1-2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1-2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0-2.1) were independent risk factors for childhood injury. Conclusion: Falls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, over- crowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries. Keywords: Childhood injuries; risk factors; Dar es Salaam; Tanzania.


Author(s):  
Akshay V. ◽  
Umashankar G. K. ◽  
Pramila M. ◽  
Ritu Maiti ◽  
Aswini M. ◽  
...  

Background: Oral health has a significant impact on quality of life of an individual but often an overlooked component of overall health. Oral diseases are emerging as a major public health concern in India and Ayushman Bharat Yojana focuses to help enhance oral health care of the entire nation. We aimed to assess the awareness and utilization of dental services under Ayushman Bharat health scheme among outpatients in Bangalore hospitals.Methods: A mixed method comprising case analysis and cross sectional observation was carried out. The annual reports data of Ayushman Bharat scheme in Karnataka was obtained for the case analysis. A cross sectional study was carried out among 150 adults in five Bangalore hospitals and data was collected using self-administered questionnaire. Descriptive statistical analysis was done using SPSS 24.Results: The study showed that 65.7% of the participants were unaware of Ayushman Bharat health insurance scheme. 25% of the participants were the beneficiaries of this scheme. Only 6% of the study participants availed general treatment under Ayushman Bharat and the treatment availed were for heart surgeries, labour and child birth, tuberculosis and cancer treatments. 12.5% of our participants were aware about dental coverage included in Ayushman Bharat insurance scheme and only 1 participant availed jaw surgery after road traffic accident under this scheme.Conclusions: This study showed there is high Out-Of-Pocket Payments (OOP) spending and lack of knowledge regarding dental coverage under Ayushman Bharat scheme.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhengyue Jing ◽  
Jie Li ◽  
Pei Pei Fu ◽  
Yi Wang ◽  
Yemin Yuan ◽  
...  

Abstract Background Previous studies have indicated that older adults with multimorbidity had higher risk of incurring catastrophic health expenditure (CHE). However, the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity remains unclear. This study aims to explore the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity, and whether this effect is moderated by economic status. Methods A cross-sectional household survey of the older adults in 2019 in Shandong province, China. A total of 606 single empty-nest elderly aged 60 years or older were included in this study. CHE was defined as the out-of-pocket payments for health care that equals or exceeds 40% of the household’ s capacity to pay. Logistic regression models are employed to examine the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity. The interaction term is introduced to explore the economic status difference in this effect. Results The CHE incidence for single empty-nest elderly with multimorbidity alone is 64.2%, and the co-occurrence of frailty results in an increase by almost 1.3 times (84.0%) in CHE incidence among single empty-nest elderly with multimorbidity. The co-occurrence of frailty increases the risk of incurring CHE among the single empty-nest elderly with multimorbidity, with the odds of incurring CHE increased by 3.19 times (OR = 3.19; P = 0.005). Furthermore, the interaction analysis shows that the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity still exist in lower economic status groups (OR = 4.64; P = 0.027), but not in higher economic status (OR = 2.76; P = 0.062). Conclusions This study demonstrates that there is a positive effect of co-occurrence of frailty on the CHE among the single empty-nest elderly with multimorbidity, and this effect varies by economic status. The health policy-makers should reorganize the healthcare system to make it pro-poor, so as to meet the multiple medical demand and reduce the potential economic burden and inequalities of older adults.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255677
Author(s):  
Hyunwoo Jung ◽  
Junhyup Lee

The catastrophic health expenditure (CHE) indicator has been used to measure the medical cost burden of households. Many countries have institutionalized their health insurance systems to reduce out-of-pocket payments, the main contributor to the financial burden. However, there is no method to estimate how the insurance coverage reduces the CHE. This study proposes an approach to evaluate the effectiveness of insurance in reducing the CHE impacts in terms of incidence and gap, which are based on a modified calculation method of CHE. Additionally, we apply these methods to data from the Korea Health Panel Survey (2011–2016). The results are as follows. First, under the setting of a threshold of 10%, the CHE incidence rate was 19.26% when the Korean national health insurance benefits reduced the CHE’s incidence for 15.17% of the population in 2017. Second, the results of the concentration index of CHE showed that the intensity approach of CHE is better than the incidence approach. Third, the new approach we applied revealed that health insurance reduces the burden of CHE to some degree, although it was not an efficient way to reduce CHE. In conclusion, this study provides new policy approaches to save the finances of national health insurance and reduce the intensity of CHE at the same time by raising the low-cost burden of medical services and lowering that of high cost. Moreover, we suggest that policymakers should focus on income level of the households rather than specific diseases.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anne Abio ◽  
Pascal Bovet ◽  
Joachim Didon ◽  
Till Bärnighausen ◽  
Masood Ali Shaikh ◽  
...  

AbstractData on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.


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