scholarly journals Awareness on health insurance and health care costs among non-communicable disease patients attending a tertiary care centre

2019 ◽  
Vol 6 (3) ◽  
pp. 1301
Author(s):  
J. Jebamalar ◽  
P. K. Kailash Kumar
Keyword(s):  
Health Insurance ◽  
Health Expenditure ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Catastrophic Health Expenditure ◽  
Communicable Diseases ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Non Communicable Diseases ◽  
The Government

Background: The silent epidemic of non-communicable diseases threatens to retard the progress towards curbing catastrophic health expenditure. The present study aimed to describe the level of awareness about and utilisation of health insurance and to measure the healthcare costs for non-communicable diseases.Methods: A total of 354 adult patients suffering from non-communicable diseases, who reside in Villupuram district and attend the NCD clinic in the Government medical college hospital, Villupuram were studied over a period of 6 months.Results: 77% of the subjects were aware of health insurance. The most frequent source of information was local government officials and the hospitals themselves. 74.01% had availed some form of health insurance. There was a moderately strong correlation between loss of wages and total health expenses. The incidence of catastrophic health expenditure due to NCD clinic visits was around 7%.Conclusions: The absence of outpatient costs in the covers of most health insurance schemes may be decreasing their effectiveness in controlling catastrophic health expenditure.

scholarly journals Ayushman Bharat Yojana: a memorable health initiative for Indians

2018 ◽  
Vol 5 (8) ◽  
pp. 3152 ◽  
Author(s):  
Rohit Dhaka ◽  
Ramesh Verma ◽  
Ginni Agrawal ◽  
Gopal Kumar
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Poverty Line ◽  
Healthcare Services ◽  
Communicable Diseases ◽  
Health And Wellness ◽  
Non Communicable Diseases ◽  
Protection Scheme ◽  
Insurance Cover ◽  
The Government

India in a state of epidemiological health transition i.e shifting from communicable to non-communicable diseases. The annually 3.2% Indians falling below the poverty line and three forth Indians spending their entire income on health care and purchasing drugs. The government of India announced a Ayushman Bharat Yojana- National Health Protection Scheme (AB-NHPM) in the year 2018.  The aim of this programme is to providing a service to create a healthy, capable and content new India and two goals are to creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services and to provide health insurance cover to at least 40% of India's population which is deprived of secondary and tertiary care services. This Yojana will be implemented through Health and Wellness Centres that are to be developed in the primary health centre or sub-centre in the village and that will provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. These centres would be equipped with basic medical tests for hypertension, diabetic and cancer and they are connected to the district hospital for advanced tele-medical consultations. The government has aims to set up 1,50,000 health and wellness centres across the country by the year 2022.

scholarly journals Non-communicable disease pattern in adults seeking preventive general health checkup

2019 ◽  
Vol 1 (1) ◽  
pp. 21-25
Author(s):  
Bikash Shrestha ◽  
Bipin Nepal ◽  
Ravi Mahat ◽  
Abish Adhikari
Keyword(s):  
General Health ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Communicable Diseases ◽  
Care Hospital ◽  
Mineral Density ◽  
Health Checkup ◽  
Middle Income ◽  
Normal Bone Mineral Density ◽  
The Government

Non Communicable diseases (NCDs) are now endemic in low and middle income countries. Nepal had a high burden of communicable diseases (CDs) which has now been overtaken by NCDs. Although prevention and control of NCDs is prioritized in national policies and strategies, there is no proper monitoring system. This study aims to review the morbidity pattern among the adults seeking preventive general health checkup in a major tertiary care hospital in Kathmandu. 3000 cases were evaluated. 53.6% were males and 46.4% were females. The mean age of cases was 44.9 yrs. Most of the cases ranged from 40 to 60 years of age. Almost half of them were from Kathmandu district. Nearly 78% participants live a sedentary life. Abdominal obesity was seen in 27.5% of females and 21.7% of males. Nearly 49% of cases were overweight and 24% were obese. Almost 21 % of the cases were smokers and about 36% of them consumed alcohol. Only 9% are vegetarians. 10% have diabetes and 20% have hypertension. 69% of females and 43% of males have less than normal bone mineral density. The government and private sectors must focus on strengthening preventive and curative services for early detection of risk factors and management of NCDs.

scholarly journals The Wedge Between Need and Access to Healthcare: Does Health Insurance Improve Utilization for People With Non- Communicable Diseases?

2021 ◽  
Author(s):  
Agness Ngwira ◽  
Maio Bulawayo ◽  
Peter Hangoma
Keyword(s):  
Health Insurance ◽  
Health Facility ◽  
Health Expenditure ◽  
Quantitative Research ◽  
Healthcare Access ◽  
Communicable Diseases ◽  
Health Coverage ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Insurance Cover

Abstract BackgroundWith progress towards universal health coverage (UHC) the disease burden of non-communicable diseases (NCDs) in LMICs is increasing while inequalities in healthcare access exist. We aimed to investigate whether health insurance enables people with NCDs to utilize health services more than their counterparts without insurance.MethodsUsing a quantitative research method and data from the Zambia Household Health Expenditure Utilization Survey (ZHHEUS, 2013) conducted in 2013, we focussed on the people who recalled visiting a health facility a month prior to the survey, 8,146 of whom said yes. Approximately 2247 had an NCD while 229 were covered by health insurance. Only women age 15-49 and men age 15-59 who were interviewed for information regarding themselves and other members of the household. The survey included questions on demographics, health status (self-rated health); illness experiences, healthcare utilization (visits, admission, type of providers sought, health expenditure); and insurance cover. Specifically, individuals were asked if they had visited a health facility in the 4 weeks preceding the survey. ResultsWe find that NCDs are associated with an increase in healthcare use (5.4 percentage points (pp); 95% CI -0.28 to 0.09; p=<0.001). Utilization increases further for those with NCDs by having health insurance (6.4pp; 95% CI -0.18 to 0.05; p=0.285) though the association was not statistically significant. Having health insurance itself, regardless of NCD status, is associated with a higher utilization (6.4pp; 95% CI -0.13 to 0.0005; p=0.048). ConclusionsOur results suggest that health insurance may play an important role in improving access among people with chronic conditions, and since they mainly affect poorer households, health insurance may have a strong equity result in a low- and middle-income country context.

scholarly journals Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

2019 ◽  
Vol 3 (5) ◽  
pp. 327-336 ◽  
Author(s):  
Deepak Raj Paudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Expenditure ◽  
Health Care Expenditure ◽  
Catastrophic Health Expenditure ◽  
Health Concern ◽  
Government Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

High expenditure due to health care is a noted public health concern in Nepal and such expenditure is expected to reduce through the access to health insurance. This study determines the factors affecting household’s catastrophic health care expenditure in Kailali district, where the government health insurance program was first piloted in Nepal. A cross-sectional survey was conducted from January to February 2018 among 1048 households (6480 individuals) after 21 months of the execution of the social health insurance program.  For the sample selection, wards were selected in the first stage followed by the selection of the households. Overall, 17.8% of the households reported catastrophic health expenditure using a threshold of more than 10% of out-of-pocket payment to total household expenditure. The study found that households without having health insurance, low economic status, and head with low level of education were more likely to face catastrophic spending. The findings suggest a policy guideline in the ongoing national health insurance debate in Nepal. The government health insurance program is currently at expansion stage, so, increase in insurance coverage, could financially help vulnerable households by reducing catastrophic health expenditure.

scholarly journals The impact of National Health Insurance upon accessibility of health services and financial protection from catastrophic health expenditure: a case study of Savannakhet province, the Lao People’s Democratic Republic

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Somdeth Bodhisane ◽  
Sathirakorn Pongpanich
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Expenditure ◽  
Democratic Republic ◽  
Catastrophic Health Expenditure ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Financial Protection ◽  
The Government ◽  
The Impact

Abstract Introduction Many schemes have been implemented by the government of the Lao People’s Democratic Republic to provide equity in health service utilisation. Initially, health service utilisations were fully supported by the government and were subsequently followed by the Revolving Drug Fund. In the 2000s, four health financing schemes, namely the Social Security Organization, the State Authority for Social Security, the Health Equity Fund and Community-Based Health Insurance (CBHI), were introduced with various target groups. However, as these voluntary schemes have suffered from a very low enrolment rate, the government decided to pilot the National Health Insurance (NHI) scheme, which offers a flat, co-payment system for health service utilisation. This study aims to assess the effectiveness of the NHI in terms of its accessibility and in providing financial protection from catastrophic health expenditure. Methods The data collection process was implemented in hospitals of two districts of Savannakhet province. A structured questionnaire was used to retrieve all required information from 342 households; the information comprised of the socioeconomics of the household, accessibility to health services and financial payment for both outpatient and inpatient department services. Binary logistic regression models were used to discover the impact of NHI in terms of accessibility and financial protection. The impact of NHI was then compared with the outcomes of the preceding, voluntary CBHI scheme, which had been the subject of earlier studies. Results Under the NHI, it was found that married respondents, large households and the level of income significantly increased the probability of accessibility to health service utilisation. Most importantly, NHI significantly improved accessibility for the poorest income quantile. In terms of financial protection, households with an existing chronic condition had a significantly higher chance of suffering financial catastrophe when compared to households with healthy members. As probability of catastrophic expenditure was not affected by income level, it was indicated that NHI is able to provide equity in financial protection. Conclusion The models found that the NHI significantly enhances accessibility for poor income households, improving health service distribution and accessibility for the various income levels when compared to the CBHI coverage. Additionally, it was also found that NHI had enhanced financial protection since its introduction. However, the NHI policy requires a dramatically high level of government subsidy; therefore, there its long-term sustainability remains to be determined.

scholarly journals Patterns and trends of hospital mortality due to non-communicable diseases and injuries in Tanzania: a 10- year retrospective analysis

2020 ◽  
Author(s):  
Leonard E.G. Mboera ◽  
Coleman Kishamawe ◽  
Susan F. Rumisha ◽  
Mercy G. Chiduo ◽  
Evord Kimario
Keyword(s):  
Communicable Disease ◽  
International Classification Of Diseases ◽  
Communicable Diseases ◽  
Coding System ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Chronic Respiratory Diseases ◽  
Premature Deaths ◽  
Classification Of Diseases ◽  
The Government

Abstract Background: Globally, non-communicable diseases (NCD) kill about 40 million people annually, with about three-quarters of the deaths occurring in low and middle-income countries. This study was carried out to determine the patterns, trends, and causes of non-communicable disease mortality in hospitals of Tanzania from 2006-2015.Methods: This retrospective study involved primary, secondary, tertiary, and specialized hospitals in Tanzania. Death statistics were extracted from inpatient department registers, death registers, and International Classification of Diseases (ICD) report forms. Variables collected were deceased’s age, sex, cause and date of death. The ICD-10 coding system was used to assign each death to its underlying cause. Data were analysed using STATA version 14. Results: A total of 247,976 deaths were reported during the 10 years (2006–2015) in 39 hospitals. Of the total deaths, 67,711 (27.3%) were due to non-communicable diseases (NCD) and injuries. Cardio-circulatory diseases (31.9%), cancers (18.6%), chronic respiratory diseases (18.4%), and injuries (17.9%) accounted for the largest proportion (86.8%) of deaths due to NCDs. The majority (57.6%) of deaths due to NCD occurred among males. Overall, the total deaths from NCDs increased by 153.3% from 4,298 in 2006 to 10,886 in 2015. The age group 15-59 years (53.4%) was the most affected category. The overall 10-year annual age-standardized mortality rate (ASMR) for all NCDs and injuries was 235.2 per 100,0000 population. It was higher for males (287.2/100,000) than for females (186.7/100,000). The annual ASMR increased from 11.9 in 2006 to 36.5 per 100,000 populations in 2015. Most of the NCD deaths occurred in the secondary (40.0%) and primary level hospitals (27.8%). There were variations in the type of non-communicable diseases by geographical distributions. Conclusions: There was a substantial increase in ASMR due to NCDs and injuries in Tanzania from 2006 to 2015. Most of the deaths due to NCD and injuries affected the productive young adult group and males. The burden caused by NCD in the most productive ages means that families, communities, and the nation at large suffer from premature deaths. The government of Tanzania must invest in early detection and timely treatment of NCDs to reduce premature deaths.

scholarly journals Challenges in managing an emergency and trauma ICU during COVID-19 pandemic: Perspective from a tertiary care centre in western Uttar Pradesh (India).

2021 ◽  
pp. 26-31
Author(s):  
Syed Hasan Amir ◽  
Lubna Zafar ◽  
Obaid Ahmad Siddiqui ◽  
Farah Nasreen
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Uttar Pradesh ◽  
Trauma Centre ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
The Government ◽  
Novel Coronavirus

In December 2019, a novel coronavirus (now named COVID-19) was identified as a causative agent for a cluster of pneumonia cases in Wuhan, China.1 Till March 2020, India was one among 50 countries which identified patients tested positive for COVID-19.2 One day curfew was imposed in the country on March 22, 2020 to forewarn the people about the danger the country was going to face. The government of India announced a nationwide lockdown for 21 days from March 25, 2020 with subsequent second, third and fourth lockdowns. This was done to reduce the transmission of disease and flatten the curve. The preparations to manage COVID-19 pandemic crisis began in Jawaharlal Nehru Medical College Hospital Aligarh, a tertiary care centre in western Uttar Pradesh by 15th of March 2020. In April 2020, it was declared as Level 2 COVID care hospital to deal with complicated and critical cases. The establishment of flu clinic, exclusive COVID-19 isolation ward, teleconsultation and widespread screening of patients by Reverse transcriptase polymerase chain reaction (RT PCR) were some measures undertaken to deal with the crisis. The increased burden of patients presenting with bronchopneumonia necessitated augmentation of the existent infrastructure and better utilization of resources. Emergency and trauma centre, JNMCH, AMU Aligarh was also no exception and reorganising emergency trauma ICU as COVID-19 suspect ICU made the functioning of the entire hospital a lot smoother during this unsustainable crisis situation. However, there were several challenges to overcome while designating an emergency and trauma ICU as COVID-19 suspect ICU. There is ample amount of literature available discussing the strategies for preparing a dedicated COVID ICU, however there is relative scarcity of literature on the challenges in managing an emergency and trauma ICU (ETC – ICU) during the pandemic. In this review, we discuss the strategies and planning for converting an emergency and trauma ICU into a COVID suspect ICU in a tertiary care centre in western Uttar Pradesh (India) during the pandemic and the challenges faced. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.26-31

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