scholarly journals Household financial burden associated with health care for older people in Viet Nam: A cross-sectional survey

2021 ◽  
Author(s):  
Nguyen Hoang Giang ◽  
Nguyen The Vinh ◽  
Hoang Thi Phuong ◽  
Nguyen Thi Thang ◽  
Tran Thi Mai Oanh
Keyword(s):  
Health Care ◽  
Older People ◽  
Financial Distress ◽  
Financial Burden ◽  
Health Expenditures ◽  
Noncommunicable Diseases ◽  
Viet Nam ◽  
Cross Sectional ◽  
Household Members ◽  
Financial Burdens

Abstract Background Population ageing and the associated increase in the health care needs of older people are putting pressure on the health care system in Viet Nam. The country prioritizes health care for older people and has developed financial protection policies to mitigate financial hardship due to out-of-pocket health expenditures (OOPHEs) borne by their households. This study examines the level and determinants of the financial burden of OOPHE among households with people aged ≥60 years in Viet Nam. Methods A cross-sectional household survey was conducted among a sample of 1536 older people living in 1477 households in three provinces representing the North, Central and South regions of Viet Nam during 2019–2020. The financial outcomes were catastrophic health expenditure (CHE), using the World Health Organization's definition, and financial distress due to OOPHE. Multivariate binary logistic regression analysis was employed to determine the factors associated with these outcomes. Results OOPHE for older household members accounted for 86.3% of total household health expenditure. Of households with older people, 8.6% (127) faced CHE, and 12.2% (181) experienced financial distress due to OOPHE. Households were at a higher risk of incurring financial burdens related to health expenditures if they had fewer household members; included only older people; were in rural or remote, mountainous areas; and had older members with noncommunicable diseases. There was no significant association between health insurance coverage and financial burden. However, when older people sought tertiary care or private care, the possibility of a household facing CHE increased. Regardless of the type and level of care, health service utilization by older people results in a higher likelihood of a household encountering financial distress. Conclusions This study reveals that OOPHE for older people can impose substantial financial burdens on households, leading them to face CHE and financial distress. This study provides evidence to justify reforming financial protection policies and introducing policy interventions targeted at better protecting older people and their households from the financial consequences of OOPHE. There is also the need to strengthen the grassroots health facilities to provide primary care closer to home at lower costs, particularly for the management of noncommunicable diseases.

scholarly journals Out-of-Pocket Expenses Related to Aging in Place for Older People Experiencing Frailty: A Scoping Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 875-875
Author(s):  
Elaine Moody ◽  
Rebecca Ganann ◽  
Marilyn Macdonald ◽  
Lori Weeks ◽  
Liz Orr ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Scoping Review ◽  
Health Care Systems ◽  
Aging In Place ◽  
Community Dwelling ◽  
The Body ◽  
Cross Sectional ◽  
Functional Changes ◽  
Out Of Pocket Expenses

Abstract Supporting older people to live in the community as they experience health and functional changes has become a priority for policy makers, health system leaders and community members, including many older people themselves. Aging-in-place has been promoted as a way to support the sustainability of health care systems and limit health care and societal costs. However, the expenses borne by individuals and caregivers to support older people to age-in-place when experiencing changes in health and functional ability are often not considered in health care literature and policy. We conducted a scoping review using Joanna Briggs Institute methodology to explore the out-of-pocket expenses for people with frailty living in the community. We included research and policy papers on community-dwelling people over 60 and experiencing frailty. Findings about financial out-of-pocket expenses were extracted. A total of 9669 sources were screened by two reviewers and 42 sources were included. The sources were from 17 countries, most from the US, and had various designs, including 14 qualitative designs, 15 cross sectional, 11 other quantitative and 2 policy discussions. The sources most often reported expenses related to home care (16), medication (12), housekeeping (10), transportation (8), and medical equipment (6). Gaps in the body of literature include lack of a consistent measure of out-of-pocket expenses and cost considerations of co-housing programs. The context—including policy, community and personal—was particularly important to the experience of out-of-pocket expenses for people with frailty, and further research is needed to expand on this knowledge.

scholarly journals The Financial Burden of Non-Communicable Chronic Diseases in Rural Nigeria: Wealth and Gender Heterogeneity in Health Care Utilization and Health Expenditures

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0166121 ◽  
Author(s):  
Wendy Janssens ◽  
Jann Goedecke ◽  
Godelieve J. de Bree ◽  
Sunday A. Aderibigbe ◽  
Tanimola M. Akande ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Chronic Diseases ◽  
Financial Burden ◽  
Health Expenditures ◽  
Care Utilization ◽  
Rural Nigeria ◽  
And Gender

scholarly journals The capacity of informal caregivers in the rehabilitation of older people after a stroke

2021 ◽  
Vol 39 (2) ◽  
Author(s):  
Mariane Lurdes Predebon ◽  
Fernanda Laís Fengler Dal Pizzol ◽  
Naiana Oliveira Dos Santos ◽  
Carla Cristiane Becker Kottwitz Bierhals ◽  
Idiane Rosset ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Older Adult ◽  
Informal Caregivers ◽  
Descriptive Study ◽  
Southern Brazil ◽  
Older Person ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Sociodemographic Data

Objective. To characterize informal caregivers of dependent older people after a stroke related to aspects of care, and to describe the activities performed and the difficulties faced by these caregivers. Methods. Cross-sectional, descriptive study, held in southern Brazil with 190 informal caregivers of older adults after stroke. The sociodemographic data instrument and the Capacity Scale for Informal Caregivers of Elderly Stroke Patients (ECCIID-AVC), adapted and validated for use in Brazil by Dal Pizzol et al., were used. Results. Most caregivers were women (82.6%) or children (56.3%), had average schooling of 9.6 years, and the majority (68.3%) provided care for people with moderate to severe disability. The main activities carried out included: providing materials and/or support for eating (99%), dressing (98.4%), and administering medications (96.2%). Caregivers had the most difficulty with transferring and positioning activities. Conclusion. Most caregivers have adequate capacity to provide essential care to the dependent older adult after a stroke. However, a significant portion had difficulty in the activities of transferring and positioning the older person due to the lack of guidance regarding the posture to carry out these activities. The assessment of nurses regarding the activities performed and the difficulties faced by caregivers is an important strategy to identify problems and effectively attend to the needs of these individuals at all levels of health care. 

scholarly journals Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

2019 ◽  
Author(s):  
Jacqueline Warth ◽  
Marie-Therese Puth ◽  
Ulrike Zier ◽  
Niklas Beckmann ◽  
Johannes Porz ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
General Practitioner ◽  
Educational Level ◽  
Financial Distress ◽  
Access To Health Care ◽  
Physician Communication ◽  
Financial Problems ◽  
Cross Sectional ◽  
Access To Health

Abstract Background About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to health care. However, it is unclear whether those affected discuss their financial problems with general practitioners that often serve as patients’ initial medical contact. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. Methods We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate: 50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Results Less than one fourth of respondents had ever discussed financial problems with their general practitioner (n=135; 22.6%). Individuals with a high educational level were less likely to communicate about financial problems compared to those with medium educational level (aOR 0.11; 95% CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background (aOR 2.09; 95% CI 1.32-3.32), the chronically ill (aOR 1.90; 95% CI 1.16-3.13) and individuals who reported high financial distress (aOR 2.15; 95% CI 1.22-3.78) and cutting on necessities to pay for medications (aOR 1.86; 95% CI 1.12-3.09) were more likely to report communication than their counterparts after adjustment. Conclusions Few over-indebted individuals discussed financial problems with their general practitioner. The findings suggest that patients’ health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

scholarly journals Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Manoj Humagain ◽  
Rashmi Humagain ◽  
Dinesh Rokaya
Keyword(s):  
Online Survey ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Standards Of Care ◽  
Dental Practice ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Standards ◽  
Financial Burdens ◽  
The Impact

Introduction: Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal. Methods: This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments. Results: It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases. Conclusions: Dentists, patients, and dental practice are severely affected by the COVID-19.The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.

scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

scholarly journals Satisfaction to healthcare among elderly; comparison study between Egypt and Saudi Arabia

2018 ◽  
Vol 5 (8) ◽  
pp. 3180
Author(s):  
Faten Sami Ali Mostafa ◽  
Ekram M. El-Shabrawy ◽  
El Morsy Ahmed El Morsy ◽  
Shaimaa Ahmed Senosy
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Older People ◽  
Health Care Services ◽  
Care Service ◽  
Health Care Service ◽  
Care Program ◽  
Cross Sectional ◽  
Total Satisfaction ◽  
Significant Difference

Background: In the context of health care services; clinicians use consumer or patient satisfaction assessment to monitor their performance and alter the delivery of care in order to retain and attract customers. Also to determine how they can better meet the needs of patients and, so, improve patient compliance. This study was designed to examine the satisfaction status of elderly patients utilize the selected geriatric health centers in the study in a comparison way between Egypt and Saudi Arabia in order to improve the geriatric health care program in Egypt.Methods: This is a cross-sectional study to assess the geriatric service through assessing the structure, process and geriatric satisfaction from the geriatric health services by an observational checklist and questionnaire. Statistical analysis was done using SPSS version 22 and Spectrum-5 software.Results: Saudi Arabia centers were significantly higher in patients' satisfaction; there were a statistically significant difference between both countries regarding total satisfaction score (p<0.001).Conclusions: The indicators in both countries under the study suggest a growing proportion of older people in the populations. This study has revealed that efforts to improve health care service for older people have not been fully implemented. Many older people still do not satisfy the offered medical service due to several obstacles. Policymakers must invest in the systems that would encourage and facilitate formal care provision, through partnership between the state and civil society for example and through investing in both old age and family support policies.

scholarly journals Determinants of access to primary health care for the elderly in the province of Essaouira

2021 ◽  
Vol 319 ◽  
pp. 02021
Author(s):  
Hicham Mejdouli ◽  
Abdellatif Baali ◽  
Hakima Amor ◽  
Nadia Ouzennou
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Older People ◽  
The Elderly ◽  
World Health Organisation ◽  
Health Care Facilities ◽  
World Health ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Primary Health

Morocco is experiencing demographic and epidemiological changes marked by an increase in the proportion of elderly people accompanied by a growing prevalence of chronic diseases and disabilities, thus leading to an increase in the demand for health care. the Moroccan health system therefore faces the challenge of meeting the specific needs of older populations in terms of access to and use of health care services. To achieve this, the World Health Organisation (WHO) recommends a community-based approach, based on primary health care facilities (PHCFs), to the provision of services for older people. This is a descriptive, cross-sectional study based on a quantitative approach. The survey was carried out via a questionnaire intended for a sample of 739 people aged 60 years and over attending the ESSPs in the province of Essaouira between January and February of the year 2020. Our study has allowed us to understand the determinants related to the use of PHC by the elderly in the province of Essaouira. These determinants concern the characteristics of the elderly as well as the organisational and institutional aspects of the care offer. The bivariate analysis of the results showed a statistically significant association between the use of PHC by the elderly and the area of residence, gender, level of education, distance travelled to health facilities, quality of reception, and availability of medicines. Policymakers are called upon to consider the determinants of the use of PHC in order to better address the health needs of older people, and also to respond to WHO guidance in this area.

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