How much cost can one patient bear? The influence of income and education on drug purchasing decisions in Hong Kong Chinese cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19584-19584
Author(s):  
T. Chan ◽  
S. Chan ◽  
Y. Poon ◽  
J. Fok ◽  
J. Epstein ◽  
...  
Keyword(s):  
Hong Kong ◽  
Cancer Patients ◽  
Low Income ◽  
Household Income ◽  
Large Population ◽  
Purchasing Decisions ◽  
Oncology Patients ◽  
Mainland Chinese ◽  
Income Groups ◽  
Co Morbidity

19584 Background: Inflation of anticancer drug prices is a growing problem worldwide. This problem is especially challenging in Asia, where rising healthcare expectations clash with low incomes and weak insurance. To clarify the factors influencing drug purchasing decisions in this context, we conducted a survey of Hong Kong oncology patients. Methods: A questionnaire was designed to assess the effect of cost on purchasing decisions relating to drug variables such as (1) efficacy, (2) tolerability, (3) convenience, (4) safety, (5) novelty and (6) reliability. Validation of the original 33-part survey resulted in a final set of 21 questions that was administered to 51 oncology patients. These respondents were characterised in terms of age, household income, insurance, educational level, family circumstances, occupation, ethnicity, religious beliefs, prognosis, and co-morbidity. Results: Most respondents were Hong Kong (68.8%), mainland Chinese (18.8%) or Caucasian (10.4%). There was a strong correlation between household income and education. Patients from middle-income (US$7,000–14,000 per month) households were most influenced in their decisions by costs and insurance rebates, whereas those from low-income households (less than US$3,000 per month) were keenest to purchase expensive medications, whether Western or traditional Chinese remedies. Demand for drug safety was cost-inelastic across all income groups, independent of gains in efficacy. Even when free treatment was offered, therapeutic uncertainties (e.g., early-phase drugs or randomization) proved unpopular with all income groups. Only the most affluent and well-educated patients valued overall survival above disease-free survival in making decisions, suggesting that less educated cohorts did not understand these concepts. Conclusion: These data suggest that low-income cancer patients and their families may have unrealistic expectations of high-priced medications, based either on misunderstanding or cultural pressures. Greater educational efforts targeting this large population sector may be needed to avoid worsening dissatisfaction and social unrest in the future. No significant financial relationships to disclose.

scholarly journals The detection of delirium in admitted oncology patients: a scoping review

2022 ◽  
Author(s):  
Megan B. Sands ◽  
Ian Wee ◽  
Meera Agar ◽  
Janette L. Vardy
Keyword(s):  
Cancer Patients ◽  
Clinical Care ◽  
Assessment Method ◽  
Risk Of Bias ◽  
Screening Tools ◽  
Diagnostic Tools ◽  
Tool Selection ◽  
Oncology Patients ◽  
Case Ascertainment ◽  
Co Morbidity

Abstract Purpose Delirium leads to poor outcomes for patients and careers and has negative impacts on staff and service provision. Cancer rates in elderly populations are increasing and frequently, cancer diagnoses are a co-morbidity in the context of frailty. Data relating to the epidemiology of delirium in hospitalised cancer patients are limited. With the overarching purpose of improving delirium detection and reducing the morbidity and mortality of delirium in cancer patients, we reviewed the epidemiological data and approach to delirium detection in hospitalised, adult oncology patients. Methods MEDLINE, EMBASE, CINAHL, PsycINFO, and SCOPUS databases were searched from January 1996 to August 2017. Key concepts were delirium, cancer, inpatient oncology and delirium screening/detection. Results Of 896 unique studies identified; 91 met full-text review criteria. Of 12 eligible studies, four applied recommended case ascertainment methods to all patients, three used delirium screening tools alone or with case ascertainment tools sub-optimally applied, four used tools not recommended for delirium screening or case ascertainment, one used the Confusion Assessment Method with insufficient information to determine if it met case ascertainment status. Two studies presented delirium incidence rates: 7.8%, and 17% respectively. Prevalence rates ranged from 18–33% for general medical or oncology wards; 42–58% for Acute Palliative Care Units (APCU); and for older cancer patients: 22% and 57%. Three studies reported reversibility; 26% and 49% respectively (APCUs) and 30% (older patients with cancer). Six studies had a low risk of bias according to QUADAS-2 criteria; all studies in the APCU setting were rated at higher risk of bias. Tool selection, study flow and recruitment bias reduced study quality. Conclusion The knowledge base for improved interventions and clinical care for adults with cancer and delirium is limited by the low number of studies. A clear distinction between screening tools and diagnostic tools is required to provide an improved understanding of the rates of delirium and its reversibility in this population.

Minimum Wage Effects on Household Income Distribution and the Labor Market

2017 ◽  
Author(s):  
Yue Chim Richard Wong
Keyword(s):  
Hong Kong ◽  
Labor Market ◽  
Income Inequality ◽  
Income Distribution ◽  
Minimum Wage ◽  
Low Income ◽  
Household Income ◽  
Basic Income ◽  
Wage Effects ◽  
Low Income Households

It is a mistake to believe that the minimum wage helps low-income households, the workers, and, to a lesser extent, even among the high-income households. For Hong Kong to genuinely address poverty, it is far more important to study much more comprehensively the real incidence and causes of poverty and not let politics get in the way. The provision of a basic income is a far better policy than a minimum wage. Has minimum wage made a difference in helping low-income households and reducing income inequality? What effect has it had on labor market employment and unemployment?

Association between Household Income and Allergy Development in Children: The Japan Environment and Children’s Study

2021 ◽  
pp. 1-9
Author(s):  
Reiji Kojima ◽  
Ryoji Shinohara ◽  
Megumi Kushima ◽  
Sayaka Horiuchi ◽  
Sanae Otawa ◽  
...  
Keyword(s):  
Low Income ◽  
Household Income ◽  
Allergic Diseases ◽  
Food Allergies ◽  
Birth Cohort Study ◽  
Multivariate Logistic Regression ◽  
Public Health Professionals ◽  
Income Groups ◽  
Increased Risk ◽  
Low Income Groups

<b><i>Background:</i></b> Socioeconomic status has been found to be associated with allergic diseases in children, but results are inconsistent. This study aimed to assess the association between household income and the development of allergic disease in children at 3 years old. <b><i>Methods:</i></b> We used data from 72,180 participants from the Japan Environment and Children’s Study, which is a prospective birth cohort study with participants recruited from January 2011 to March 2014. We examined the associations between household income and allergic diseases (asthma, eczema, and food allergies) in children, adjusting for covariates using multivariate logistic regression. <b><i>Results:</i></b> The percentages of doctor-diagnosed allergies at 3 years old were 7.5% for asthma, 7.2% for eczema, and 6.2% for food allergies. Children from households with an annual income of &#x3c;2 million yen (approx. 18,000 USD) had a significantly higher risk of doctor-diagnosed asthma and eczema than those from households with an income of 4–6 million yen. The adjusted odds ratios (aORs) were 1.17 (95% confidence interval [CI] 1.03–1.34) and 1.21 (95% CI 1.06–1.39). Children from households with an income of &#x3e;6 million yen tended to have an increased risk of food allergies (aOR 1.07, 95% CI 0.98–1.15). <b><i>Conclusion:</i></b> Low household income was a risk for doctor-diagnosed asthma and eczema, suggesting that public health professionals should recognize low-income groups as vulnerable populations for these conditions.

scholarly journals Can Malaysia’s National Affordable Housing Policy Guarantee Housing Affordability of Low-Income Households?

2021 ◽  
Vol 13 (16) ◽  
pp. 8841
Author(s):  
Jian Liu ◽  
Huay Ying Ong
Keyword(s):  
Housing Policy ◽  
Affordable Housing ◽  
Low Income ◽  
Household Income ◽  
Housing Affordability ◽  
Housing Policies ◽  
Compliance Cost ◽  
Income Groups ◽  
Low Income Groups ◽  
Low Income Households

Housing affordability is a long-held issue in Malaysia, and housing policies have been implemented for low-income households over the years. However, there is a contradiction that housing affordability of low-income households has not been met, while the bulk of affordable housing is still vacant. In 2019, Malaysia enacted the National Affordable Housing Policy (DRMM) which was intended to improve housing affordability for low-income groups. This paper aims to answer why Malaysia’s long-term implementation of affordable housing policies cannot guarantee housing affordability, and whether the DRMM can effectively improve housing affordability as expected, by comparing the empirical factors of housing affordability. A literature review and a comparative analysis are adopted in the research. The paper concludes that low household income, high land price, construction cost and compliance cost, mismatch of supply and demand in terms of quantity, the instability of the national economy, low home financing ability, and incomprehensive housing planning have caused low housing affordability of low-income groups in Malaysia. The DRMM as anticipated can improve housing affordability by supplying affordable housing more precisely, lowering housing costs, and improving home financing ability. However, the exclusion of household income and economic factors may cause the ineffectiveness of the DRMM in improving housing affordability for low-income households.

scholarly journals Consumer Characteristics and Preferences of Rice Attributes Based on the Income Levels in Palembang

2020 ◽  
pp. 16-25
Author(s):  
. Yunita ◽  
. Lifianthi ◽  
Muhammad Arbi
Keyword(s):  
Low Income ◽  
Household Income ◽  
Consumer Preferences ◽  
Income Group ◽  
High Income ◽  
High Income Group ◽  
Rice Cake ◽  
Income Groups ◽  
Head Rice ◽  
Low Income Groups

The study was conducted on 150 respondents living in Palembang city that were randomly selected based on the assumptions of community groups that have high income groups (50 respondents), medium income groups (50 respondents), and low income groups (50 respondents). The purpose of the study is to describe the characteristics of consumers and analyze consumer preferences for rice attributes based on the level of household income in Palembang city. This showed that the characteristics of households from the three level groups, both from the high, medium, and low income groups are very diverse which can influence the decision to choose and buy rice to be consumed. Rice attributes include the level of rice extinction, rice retention, taste of rice, aromatic, type of rice, volume of development, head rice, broken grains, grain groats, lime grains, and color. Household consumer preferences based on the importance level of rice attributes for the very important category most selected in the high and medium income groups are the quality before the rice becomes rice, while the low income group is a resilience factor in rice. Household consumer preferences based on the level of preference for the attribute of rice for the category of very like the most chosen in the high income group is the taste of rice, for the medium income group is rice cake and the low income group is rice and head rice.

Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth

2017 ◽  
Vol 34 (10) ◽  
pp. 1003-1010 ◽  
Author(s):  
Lauren Keenan-Devlin ◽  
Linda Ernst ◽  
Kharah Ross ◽  
Sameen Qadir ◽  
William Grobman ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Low Income ◽  
Household Income ◽  
Chart Review ◽  
Middle Income ◽  
Inflammatory Lesions ◽  
Income Groups ◽  
Placental Inflammation ◽  
Low Income Mothers ◽  
Physical Environmental Factors

Objective This study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation. Study Design A total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors. Results Overall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28; p = 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53; p = 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14; p = 0.36). Results remained significant after adjustment for maternal age, race, and marital status. Conclusion Chronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors.

scholarly journals Urban Segregation and Socio-Spatial Interactions: A Configurational Approach

Urban Science ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 55 ◽  
Author(s):  
Ana Luisa Maffini ◽  
Clarice Maraschin
Keyword(s):  
Low Income ◽  
Household Income ◽  
Spatial Relationship ◽  
Public Spaces ◽  
Spatial Interactions ◽  
Configurational Approach ◽  
Income Groups ◽  
Inherent Feature ◽  
Low Income Groups ◽  
Configurational Model

Urban segregation is an inherent feature of cities and becomes a problem when excluding or hindering certain groups from accessing services, activities and spaces. In Brazil, segregation by social class is dominant in the structure of cities and public policies rarely address urban configuration as part of the segregation problem. This work addresses segregation with a shift in emphasis from traditional housing segregation to segregation as the restraint of socio-spatial interactions, thus including other facets of the phenomenon that have not yet been properly explored and seeking new spatially relevant metrics. This paper aims to present a methodology of segregation analysis based on configurational models and develop an empirical application in a Brazilian city. Representing the probabilities of interaction between different socio-economic groups in public spaces, a configurational model was used, addressing retail-residence spatial relationship. The attributes of population size, household income and number of retail establishments were considered. The results allowed identifying the probabilistic residence-retail trajectories for high and low income groups, providing a first measure of spatial segregation. The conclusions seek to highlight the importance of configurational approaches for segregation studies, as well as to show potentialities and limits of this methodology.

Tools to Ensure the Affordability of Food in the Context of New Challenges

2020 ◽  
pp. 128-136
Author(s):  
E. G. Reshetnikova
Keyword(s):  
Food Security ◽  
Low Income ◽  
Household Income ◽  
National Income ◽  
Domestic Demand ◽  
Theoretical Approaches ◽  
Income Groups ◽  
Staple Foods ◽  
Institutional Aspects ◽  
Wage Differentiation

The presented study examines the essence, specific features of calculation, and trends in the dynamics of food affordability, as well as the development of tools to increase real disposable household income as a crucial factor for the formation of domestic demand for food under modern conditions.Aim. The study aims to systematize theoretical approaches and analyze the institutional aspects of ensuring the affordability of food to substantiate promising directions for improving the national income and tax policy that would facilitate an increase in the aggregate demand for food.Tasks. The author examines the adjustment of the essence of the concept of “affordability” of food in the new edition of the Food Security Doctrine as a reflection of new global challenges and internal risks; assesses the current state of affordability of staple foods among the population in general and in the context of specific income groups, the dynamics of real disposable household income, and changes in the structure of effective demand; substantiates recommendations for the development of the institutional component of real income regulation and taxation of individuals.Methods. This study uses comparison, systems analysis, systematization of information, and the monographic method.Results. The ratio of actual consumption of staple foods, rational consumption rates for Russian households in general and in the context of specific income groups are analyzed. Food products that are currently not affordable are identified. Structural changes in the consumer demand of low-income groups are determined. The parameters of inter-industry, intra-industry, and regional wage differentiation that have a negative impact on the quality of life and affordability of food are analyzed. The conducted study shows that there is currently a high tax burden on individuals in Russia, composed of direct and indirect taxes.Conclusions. The author substantiates the advisability of including a decrease in real household income and the ensuing insufficiently high aggregate domestic demand for food in the list of economic risks provided by the Food Security Doctrine; shows that adhering to the monetarist model of economic development leads to a low inflation rate but does not create conditions for accelerated economic growth and exacerbates the problems of poverty and socio-economic differentiation; proves that under modern conditions it is advisable to improve the national income policy by increasing the real disposable income of the most deprived part of the population and developing small forms of agribusiness and food trade to expand the competitive environment of the food market. The author emphasizes the importance of improving the institutional aspects of regulating various types of wage differentiation and concludes that there are objective prerequisites for the transition to progressive taxation and introduction of a non-taxable part of income at a subsistence level for the most deprived segments of the population.

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