scholarly journals Fairness evaluation for the elder population in China

2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen

Abstract Background: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare.Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.

2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen

Abstract Background: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.


2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen

Abstract Introduction: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Kakwani indexes and curves were obtained from concentration index/ curves and Gini coefficient/ATP for progressivity analysis in healthcare financing. Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions. Key words : Non-communicable diseases, the elderly, socioeconomic status, health financing, kakwani index


2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen

Abstract Background: Population aging and the increasing burden of non-communicable diseases (NCDs) are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases, as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China during the year of 2007 to 2010. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of healthcare financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in Non-NCD, single morbidity and multi-morbidity groups with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare between 2007 to 2010. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.


Proceedings ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 34
Author(s):  
Ana Lúcia Morais ◽  
Patrícia Rijo ◽  
Belén Batanero ◽  
Marisa Nicolai

Presently, long-lasting health disorders represent a significant health problem in developing countries. Further, epidemiological trends associated with lifestyle habits suggest that chronic conditions tend not to slow down all over the world. As such, reliable analytical techniques to manage chronic health conditions such as diabetes-mellitus, cardiovascular diseases and neurodegenerative diseases, among other non-communicable diseases (NCD), are of paramount importance.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.


2021 ◽  
Vol 16 (2) ◽  
pp. 35-39
Author(s):  
Md Mazharul Islam Khan ◽  
Ariful Haque ◽  
- Md Shamimuzzaman ◽  
Chyochyo Nancy ◽  
Farzana Zafreen

Introduction: Non-communicable diseases (NCDs) have become burning issues worldwide, especially among the elderly individuals. Bangladeshi elderly is also susceptible cohort to NCDs for its recent epidemiologic transition and the NCDs is casting as prominent risk for major mortality and morbidity related issues. Objectives: To find out the prevalence of common NCDs and its risk factors among the Bangladeshi retired military personnel. Methods: This cross-sectional study was conducted among the retired military personnel admitted in Combined Military Hospital (CMH), Savar from January 2019 to July 2019. A face-to-face interview was carried out among the respondents using a semi-structured questionnaire. Results: Among 153 retired military personnel; most common NCDs were hypertension (80.4%), diabetes mellitus 66.7%, ischemic heart disease37.3% and only 3.9 % had low back pain. Most of them accessed their health in CMH (66.7%), where 17.6% reported to Govt. hospital and only a minor portion (15.7%) to private hospital. Moreover, 70.6% of them were not willing to regular health check-up. Conclusions: The most common NCDs were hypertension, diabetes mellitus and ischemic heart disease. This study concluded with a few intervention strategies and community-based health promotion programs to reduce the burden of NCDs among the retired military personnel. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 35-39


2017 ◽  
Vol 5 ◽  
pp. 943-947
Author(s):  
Teodora Dimcheva ◽  
Boryana Levterova ◽  
Desislava Bakova ◽  
Nonka Mateva

Introduction: The prevalence of chronic non-communicable diseases (NCDs) worldwide acquires epidemic dimensions. In Europe, five nosological groups (diabetes mellitus, cardiovascular disease, cancer, chronic respiratory diseases and mental disabilities) constitute 77% of NCDs and cause about 86% of deaths in the region.Objectives: This study aimed to assess the quality of life in patients with chronic non-communicable diseases under dispensary observation.Methods: The pilot cross-sectional study was performed among adult with chronic diseases in primary care practices in the Plovdiv district (the second largest in Bulgaria) from May to June 2013.Results: A total of 200 adults with chronic diseases participated in the study. The mean age was 55.6 years (range 25–95, standard deviation (SD) 16.9). The most common chronic diseases in our study were cardiovascular 51% (ischemic heart disease, hypertension, etc.), followed by endocrinology diseases (23%). There was statistically significant differences in the assessments of "general health" in different groups of participants by gender (χ2 = 16.65, P <0.002), age (χ2 = 12.57, P <0.05) and social status (χ2 = 28.54, P <0.0001).Conclusion: The subjective assessment of health is a factor that has a strong impact on the quality of life of patients and is an important component in evaluating the effectiveness of provided health care for patients with chronic non-communicable diseases.


2020 ◽  
Vol 3 (2) ◽  
pp. 48
Author(s):  
Isnaeni Rofiqoch

Non-Communicable Diseases (NCD) is one of the causes of death in the world. Indonesia is a developing country that is facing a double burden of diseases, namely infectious diseases and non-communicable diseases. NCD can appear without symptoms and show no clinical signs, so many people are not aware of the dangers of NCD disease. The purpose of this comunity service is to provide counseling about NCD and measure blood pressure in an effort to detect NCD Early.This community service uses counseling as a method to increases partner knowledge in early detection of NCD. The average of partners knowledge increase by 42.6%. This is calculated by comparing the pre test average value of 5.70 and the post test average value of 8.20. Implementation of community service can increase the knowledge of the elderly posyandu group of Sokaraja Kulon Village so that the participants have the desire to prevent NCD and find out blood pressure from blood pressure measurement results in order to reduce the causes of non-communicable diseases (NCD) and have the intention to inform knowledge about Non-Communicable Diseases (NCD) to Family, Relatives and Communities.Keywords :Early Detection,Non-Communicable Diseases


2021 ◽  
Vol 10 (17) ◽  
pp. e18101724202
Author(s):  
Saulo Vasconcelos Rocha ◽  
Sabrina Correia de Oliveira ◽  
Hector Luiz Rodrigues Munaro ◽  
Camila Fabiana Rossi Squarcini ◽  
Bruna Maria Palotino Ferreira ◽  
...  

Negative health behaviors incorporated into lifestyle are considered the main risk factors for chronic non-communicable diseases (NCDs) in adults and the elderly. However, the relationship between the aggregation of these factors and the sociodemographic conditions of the elderly needs to be better elucidated. The aim of this study was to analyze the simultaneity of the five risk factors for NCDs in the elderly with low economic status living in a rural city in Brazil, and their association with sociodemographic variables. Cross-sectional study was conducted with elderly people from Family Health Units of the city of Ibicui-Bahia, Brazil, where 310 elderly were enrolled. Rates of physical inactivity in leisure (PIL), alcohol consumption, sedentary behavior, overweight/obesity and tobacco consumption were collected through a questionnaire in an individual interview. The average age among participants was 71.62 (± 8.16) years. The group presenting the five behaviors had high scores in both sexes (men O/E = 242.5; women O/E = 161.7). Among men and women, the highest scores found through clustering of simultaneous NCD risk factors were for the consumption of alcohol with smoking, and physical inactivity with smoking. When analyzing the association between groups and sociodemographic characteristics, men were more physically inactive than women (OR = 0.96, CI = 0.92-0.98) and concomitantly had unhealthy habits (smoking). In conclusion, the elderly are exposed to health risk factors for concurrent CNCDs and the accumulation of these risk factors was not associated with sociodemographic variables, it is suggested that further studies be carried out with the prevalent variables as well as to analyze why the elderly population presents these levels.


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