scholarly journals Economic Burden of Inpatient Wound Dressing in Nigeria: Implication for Catastrophic Household Expenditure

2022 ◽  
Author(s):  
Kolawole Damilare Ogundeji ◽  
Patrone Rebecca Risenga ◽  
Gloria Thupayagale-Tshweneagae
Keyword(s):  
Low Income ◽  
Economic Burden ◽  
Wound Dressing ◽  
Scale Up ◽  
Length Of Hospital Stay ◽  
Teaching Hospitals ◽  
Household Expenditure ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Coping Capacity

Abstract Background: The literature is replete with family impoverishment resulting from out of pocket healthcare financing on the Africa continent. In Nigeria the healthcare insurance scheme is evolving and requires wider coverage. The aim of this study is to examine catastrophic household expenditure emanating from daily or alternate day wound dressing.Methods. The study was based on a descriptive cross-sectional research design to investigate the economic burden of daily or alternate day wound dressing among hospitalized patients in selected teaching hospitals in south west Nigeria. The inclusion criteria focused on inpatients about to be discharged or already spent minimum of four weeks in hospital. The data collection instrument was pre-tested with a coefficient of stability of 0.774. Respondents were selected via convenience sampling while an interview administered questionnaire was used to elicit information on wound care from patients in medical surgical wards. Covid-19 protocols were strictly adhered to and ethical approval was sought from each hospital.Results: The result revealed that the mean age of the respondents was 44.95 ± 16.12. Two-thirds were men who are artisans and traders with only secondary school education. Over 70% of the respondents have between 5 and 10 family members, more than 50% earn less than ₦50000 per month. The majority have no comorbidities (79.5%), about 50% were on daily dressing which required 1–5 moderate or major dressing packs per week. The length of hospital stay for the majority of the respondents (85.3%) was less than 11 weeks.Conclusions: The daily or alternate day wound dressing requires a financial input beyond the coping capacity of the indigenous Nigerian families. The Nigerian government should scale up coverage of health insurance scheme to cover artisans, small traders and other low income earners to reduce the incidence of catastrophic household expenditure.

scholarly journals Socioeconomic Disparities in Drugs and Substance Abuse: results from a Household Cross-sectional Survey in Murang’ a County, Kenya

2020 ◽  
Author(s):  
Vincent Omondi Were ◽  
Collins Omondi Okoyo ◽  
Sylvie Biyaki Araka ◽  
Henry Muriuki Kanyi ◽  
Elizabeth Echoka Echoka ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Prescription Drugs ◽  
Low Income ◽  
Economic Burden ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional ◽  
Middle Income ◽  
Household Level ◽  
Income Groups ◽  
Economic Inequalities

Abstract IntroductionDrugs and substance abuse has adverse health effects and substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic inequalities disparities in drugs and substance abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic inequalities in a selected county of central Kenya.MethodThe study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with a least one person who uses any drugs or substance of abuse were randomly sampled from 4 purposively selected sub-locations of Murang’ a County, central Kenya. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established ( low, middle, and high SES ) using principal component analysis f(PCA) from a set of household assets and characteristics. Multivariate logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance of abuse.ResultsIndividuals in higher SES were more likely to use cigarettes ( OR = 2.13; 95%CI = 1.25–3.61, p = 0.005) or piped tobacco (OR = 11.37; 95% CI, 2.55–50.8; p-value = 0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR = 0.39; 95%CI = 0.21–0.71, p = 0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly higher amount than the poorest individuals (Ksh 1500 vs. Ksh 1000, p = 0.0310). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR = 2.96; 95%CI = 1.03–8.45).ConclusionSocioeconomic disparities exist in the use of drugs and substance abuse. The low-income individuals are at a higher risk of abuse and thus of economic burden due to catastrophic expenditure in acquiring the drugs. Cases of deaths were likely to occur in middle-income groups. Strategies to reduce drugs and substance abuse must address socio-economic inequalities through targeted approaches to individuals in low-income groups.

scholarly journals Husband’s Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India

2016 ◽  
Vol 33 (14) ◽  
pp. 2241-2267 ◽  
Author(s):  
Jennifer A. Wagman ◽  
Balaiah Donta ◽  
Julie Ritter ◽  
D. D. Naik ◽  
Saritha Nair ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Alcohol Use ◽  
Low Income ◽  
Partner Violence ◽  
Access To Health Care ◽  
Scale Up ◽  
Intimate Partner ◽  
Design Strategies ◽  
Cross Sectional ◽  
Increased Risk

Husbands’ alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women’s reports of their husbands’ alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands’ past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women’s husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man’s increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands’ drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men’s alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband’s use of alcohol. There is need to scale up proven successful interventions for reducing men’s alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.

scholarly journals Inequality in Health: The Correlation between Poverty and Injury—A Comprehensive Analysis Based on Income Level in Taiwan: A Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 349
Author(s):  
Shi-Hao Huang ◽  
Shih-Chun Hsing ◽  
Chien-An Sun ◽  
Chi-Hsiang Chung ◽  
Chang-Huei Tsao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Mortality Rate ◽  
Nonprofit Organizations ◽  
Low Income ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Income Group ◽  
National Health Insurance System ◽  
Cross Sectional ◽  
The Government

Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher’s exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of “fall,” “suicide,” and “homicide” incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.

scholarly journals Modelling Outpatients Cost of Wound Dressing in Nigeria: A Prospective Study

2022 ◽  
Author(s):  
Kolawole Damilare Ogundeji
Keyword(s):  
Direct Cost ◽  
Wound Dressing ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Teaching Hospitals ◽  
P Value ◽  
Cross Sectional ◽  
Health Maintenance ◽  
South West

Abstract Background: Estimating the direct cost of wound dressing poses a challenge to patients, nurse managers, hospital administrators, health maintenance organisations and other policy makers. This study therefore model the weekly cost of wound dressing in South West NigeriaMethods: A descriptive cross sectional research design was utilized to assess the cost of wound dressing among outpatients’ clinics attendees. An inventory of direct cost of wound dressing per week consisting of cost of materials, lotion and consumables were recorded. The data collection was for period of three months in three selected Teaching Hospitals South West Nigeria. Then modelling weekly cost of wound types was done by regression analysis. The effect of various independent variables such as age, occupation, family size, monthly income, aetiology, diagnosis, wound type, comorbidities, frequency of wound dressing and health insurance coverage on cost of wound dressing per week was considered. Ethical approval was obtained from each of the hospital and Covid-19 precautions were observed.1 USD equalled ₦570Results: The estimated cost of wound dressing per week with no contribution from other variables was found to be ₦36,922- Open wound, ₦6011-Leg ulcer, ₦3768- Cancer wound, ₦2785- Diabetic Foot Ulcer, ₦610-Surgical wound. Only frequency of wound dressing was found to contribute to weekly cost of leg ulcers (P value= 0.003)Conclusions: The estimated cost of various type of wound provides yardstick for determining the weekly cost of wound dressing in Nigeria. Also, frequency of wound dressing is a major determinant of the outpatient cost of dressing. Therefore, it is imperative for nurses to render high quality wound care to match up with the huge financial commitment from patients and families

scholarly journals Socioeconomic Disparities in Drugs and Substance Abuse: Results from a Household Cross-sectional Survey in Murang’ a County, Kenya

2021 ◽  
Author(s):  
Vincent Omondi Were ◽  
Collins Omondi Okoyo ◽  
Sylvie Biyaki Araka ◽  
Henry Muriuki Kanyi ◽  
Elizabeth Echoka Echoka ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Low Income ◽  
Economic Burden ◽  
Multivariate Logistic Regression Analysis ◽  
Socioeconomic Disparities ◽  
Cross Sectional ◽  
Middle Income ◽  
Economic Disparities ◽  
Household Level ◽  
Income Groups

Abstract Background: Drug and substance abuse has adverse health effects and a substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic disparities in drugs and substance abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic disparities in Murang’a county of central Kenya.Method: The study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with at least one person who uses any drug or substance of abuse were randomly sampled from 4 purposively selected sub-locations of Murang’ a County. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established (low, middle, and high SES ) using principal component analysis f(PCA) from a set of household assets and characteristics. Multivariate logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance abuse. Results: Individuals in higher SES were more likely to use cigarettes ( OR=2.13; 95%CI=1.25-3.61, p=0.005) or piped tobacco (OR=11.37; 95% CI, 2.55-50.8; p-value=0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR=0.39; 95%CI=0.21-0.71, p=0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly higher amount than the poorest individuals (Ksh 1500 vs. Ksh 1000, p=0.0310). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR=2.96; 95%CI=1.03-8.45). Conclusion: Socioeconomic disparities exist in the use of drugs and substance abuse. The low-income individuals are at a higher risk of abuse and thus of economic burden due to catastrophic expenditure in acquiring the drugs. Cases of deaths were likely to occur in middle-income groups. Strategies to reduce drugs and substance abuse must address socio-economic disparities through targeted approaches to individuals in low-income groups.

Surgical informed consent in Iran—how much is it informed?

2013 ◽  
Vol 21 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Somayeh Faghanipour ◽  
Soodabeh Joolaee ◽  
Marzieh Sobhani
Keyword(s):  
Informed Consent ◽  
Length Of Hospital Stay ◽  
Teaching Hospitals ◽  
Sufficient Information ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Essential Information ◽  
Data Provision ◽  
Complications Of Surgery ◽  
Potential Risks

Introduction: Informed consent constitutes one of the most important legal, professional, and ethical principles of a surgical operation. Consent obtained from a patient is only valid when the patient has received enough information regarding the proposed treatment option. This study aims to determine how much the patients are informed before undergoing surgery, as well as the factors influencing it in hospitals affiliated with Tehran University of Medical Sciences. Method: This is a cross-sectional, descriptive–analytic study of 300 patients undergoing surgery in 7 teaching hospitals affiliated with Tehran University of Medical Sciences. The patients were recruited through clustered sampling. Data were collected using a questionnaire completed by interview. Data were analyzed on SPSS software using descriptive and inferential statistics. Result: The mean score of data provision for patients was 27.09 out of 60, indicating the level of information provided as unacceptable. Among 12 questions dealing with data provision, patients had received an intermediate level of information about nature of the disease, type of surgery, benefits and importance of the surgery, and complications of rejecting the recommended therapy. On the contrary, they had not received enough information about the surgical procedure, type of anesthesia, potential complications of surgery, potential risks of surgery, other therapy options instead of surgery, length of hospital stay for surgery, postsurgical follow-up, and expenses of the surgery. In the majority (85%) of cases, the surgeon was reported to be the information provider. Among the variables studied, level of information received was directly related to the patient’s education level. Discussion: The findings of this study indicate that during the process of obtaining an informed consent for surgery, patients do not receive sufficient information, and it is necessary to provide the essential information in an understandable manner adjusted for the patient’s level of education.

scholarly journals Predictors of prolonged length of hospital stay for infants with bronchiolitis

2018 ◽  
Vol 66 (6) ◽  
pp. 986-991 ◽  
Author(s):  
Carlos E Rodríguez-Martínez ◽  
Monica P Sossa-Briceño ◽  
Gustavo Nino
Keyword(s):  
Hospital Stay ◽  
Low Income ◽  
Length Of Hospital Stay ◽  
Clinical Information ◽  
Underlying Disease ◽  
Initial Manifestation ◽  
Cross Sectional ◽  
Prolonged Length ◽  
History Of ◽  
Syncytial Virus

Among inpatients suffering from bronchiolitis, approximately a quarter may undergo a prolonged length of stay (LOS) for the treatment of their respiratory condition. However, there have been few research studies that have evaluated variables that may be associated with a prolonged LOS in these patients, especially in low-income and middle-income countries, where the clinical and economic burden of the disease is the greatest. In an analytical single-center cross-sectional study, we included a population of patients with acute bronchiolitis hospitalized between March and June 2016. We collected demographic and clinical information and the LOS of each patient. Prolonged LOS for bronchiolitis was defined as at least one hospital stay of 5 or more days. A total of 303 patients were included, with 176 (58.1%) male and a median (IQR) age of 3.0 (1.0–7.0) months. After controlling for gender, history of bronchopulmonary dysplasia, number of days with respiratory symptoms, the presence of apnea as an initial manifestation of bronchiolitis, and other underlying disease conditions, we found that the independent predictors of prolonged LOS for bronchiolitis in our study population included age (OR 0.92; 95% CI 0.84 to 0.99; p=0.049), history of prematurity (OR 6.34; 95% CI 1.10 to 36.46; p=0.038), respiratory syncytial virus isolation (OR 1.92; 95% CI 1.02 to 3.73; p=0.048), and initial oxygen saturation (OR 0.94; 95% CI 0.88 to 0.98; p=0.048). The factors identified should be taken into account when planning policies to reduce the duration of hospital stay in infants with bronchiolitis.

scholarly journals Willingness of Households to Pay Community Based Health Insurance and its Associated Factors in Mecha District, Northwest Ethiopia: Community based Cross-sectional Study

2021 ◽  
Author(s):  
Getaneh Bizuayehu Demeke
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Associated Factors ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance

Abstract Background Community-based health insurance schemes helps to give financial protection and decrease direct out- of-pocket payment for health care based on the assumption of risk-pooling and community solidarity to risks of falling sick. Ethiopia is a low income country with more of health spending out of pocket payment by households. Community based health insurance was introduced in Ethiopia in 2010.It covers only the rural community and informal sector. Objectives this study aimed to assess willingness of households to pay community based health insurance and its associated factors in Mecha district, Northwest, Ethiopia. Methods Community based cross-sectional study design was used to collect data from 285 household heads using multistage sampling techniques in Mecha district Northwest Ethiopia. The data were collected by using trained data collectors and using a pre-tested structured questionnaire. A binary logistic regression model was used to determine the presence of statistically significant associations between the dependent and independent variables at p-value < 0.05 and AOR values with 95% CI. Results From the total of 296 sampled respondents, 285 participated in the study with the response rate of 96.3%. Of these, 251(88.1%) were willing to join voluntary as well as 34(11.9%) were join mandatory and 256(89.8%) of them were willing to pay community based health insurance services. The average amount of money the households were willing to pay per household per annum was 334.02 ETB found with the interval of (317.32–351.30) with the range between 240–1000 ETB. Conclusions The willingness of house hold heads to pay for the community-based health insurance was high. Residence, join CBHI, premium affordable, CBHI have an advantage and distance from households home to HF were more willing to pay CBHI schemes. The study indicated that high willing to pay and low CBHI package fulfil the needs of HH treatment as well as overall CBHI service level was poor. Therefore, Mecha district CBHI coordinating office should be scale up the community-based health insurance services in the scheme.

scholarly journals Perception and utilization of tetanus toxoid immunization among pregnant women attending a tertiary centre in North-West Nigeria

2018 ◽  
Vol 8 (6) ◽  
pp. 119-124
Author(s):  
KJ Awosan ◽  
M Hassan
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Tetanus Toxoid ◽  
Scale Up ◽  
Low Income Countries ◽  
Systematic Sampling ◽  
Cross Sectional ◽  
North West ◽  
Tertiary Centre ◽  
Tetanus Toxoid Immunization

Background: Despite the availability of inexpensive and effective tetanus-toxoid-containing vaccines, elimination of maternal and neonatal tetanus worldwide has become a herculean task, particularly in low-income countries, due to poor immunization coverage. This study aimed to assess the perception and utilization of tetanus toxoid immunization among pregnant women attending a tertiary centre in North-West Nigeria. Materials and Methods: A cross-sectional study was conducted among 254 pregnant women (selected by systematic sampling technique) attending the antenatal clinic of Specialist Hospital, Sokoto, Nigeria. A structured interviewer-administered questionnaire was used to collect data on the research variables. Data were analyzed using IBM SPSS version 20 statistical computer software package. Results: Most, 221 (87.0%) of the 254 respondents had heard of tetanus toxoid immunization. Of these, only about half (51.1%) believed that it protects both mother and newborn baby from tetanus. Majority of respondents considered TT immunization to be effective in protecting against tetanus infection (73.3%) and also safe for both mother and baby (79.2%). About two-thirds of respondents (68.8%) had the misconception that a single dose of TT immunization protects from tetanus infection. Less than a quarter of respondents (23.6%) had received two or more doses of the vaccine. The main barriers to utilization of vaccines were lack of awareness of the vaccine (41.8%), not being aware of its benefits (36.7%), and fear of side effects (21.5%) Conclusion: Despite high levels of perception of the effectiveness and safety of TT immunization, the respondents in this study had low levels of perception and utilization of the protective doses of the vaccine. Government and healthcare workers should scale-up education of the populace on TT immunization schedule and implement community based vaccination of women of child bearing age in North-West Nigeria. Keywords: Perception, utilization, tetanus toxoid immunization, pregnant women

A View of the Lexical–Grammatical Link in Young Latinos With Specific Language Impairment Using Language-Specific and Conceptual Measures

2019 ◽  
Vol 62 (6) ◽  
pp. 1775-1786 ◽  
Author(s):  
Lucía I. Méndez ◽  
Gabriela Simon-Cereijido
Keyword(s):  
Low Income ◽  
Language Impairment ◽  
Specific Language Impairment ◽  
L2 Acquisition ◽  
Cross Sectional ◽  
Specific Language ◽  
Vocabulary Skills ◽  
In The Beginning ◽  
Study Participants ◽  
L1 And L2

Purpose This study investigated the nature of the association of lexical–grammatical abilities within and across languages in Latino dual language learners (DLLs) with specific language impairment (SLI) using language-specific and bilingual measures. Method Seventy-four Spanish/English–speaking preschoolers with SLI from preschools serving low-income households participated in the study. Participants had stronger skills in Spanish (first language [L1]) and were in the initial stages of learning English (second language [L2]). The children's lexical, semantic, and grammar abilities were assessed using normative and researcher-developed tools in English and Spanish. Hierarchical linear regressions of cross-sectional data were conducted using measures of sentence repetition tasks, language-specific vocabulary, and conceptual bilingual lexical and semantic abilities in Spanish and English. Results Results indicate that language-specific vocabulary abilities support the development of grammar in L1 and L2 in this population. L1 vocabulary also contributes to L2 grammar above and beyond the contribution of L2 vocabulary skills. However, the cross-linguistic association between vocabulary in L2 and grammar skills in the stronger or more proficient language (L1) is not observed. In addition, conceptual vocabulary significantly supported grammar in L2, whereas bilingual semantic skills supported L1 grammar. Conclusions Our findings reveal that the same language-specific vocabulary abilities drive grammar development in L1 and L2 in DLLs with SLI. In the early stages of L2 acquisition, vocabulary skills in L1 also seem to contribute to grammar skills in L2 in this population. Thus, it is critical to support vocabulary development in both L1 and L2 in DLLs with SLI, particularly in the beginning stages of L2 acquisition. Clinical and educational implications are discussed.

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