scholarly journals Household Expenditures And Direct Medical Costs Among Older Adults In Ghana: Evidence From Who-sage Wave 2

2020 ◽  
Author(s):  
Paa-Kwesi Blankson ◽  
Sandra Ama Hewlett ◽  
Thomas Akuetteh Ndanu ◽  
Gyaami Amoah ◽  
Matthew Owusu Boamah ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Protection ◽  
Financial Burden ◽  
World Health ◽  
Household Expenditure ◽  
Adult Health ◽  
Health Coverage ◽  
Financial Risk Protection ◽  
Younger Adults ◽  
Household Expenditures

Abstract Background: The Ghanaian population aged 60 years and older will almost double to reach 10% of the total population by 2050. Ascertaining the pattern of health expenditures among this growing population group is important to inform policy makers about the targets for financial risk protection as part of achieving Universal Health Coverage (UHC) by 2030. This study aimed to estimate household expenditures among older adults and determine the direct medical costs.Methods : The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 was conducted in China, Ghana, India, Mexico, Russian Federation, and South Africa between 2014 and 2015, as a follow-up to Wave 0 in 2003 to 2004 and Wave 1 in 2007 to 2010. Survey questions explored sources of income and total direct expenditures in the year preceding interview. SAGE Ghana was implemented using face-to-face interviews in a nationally representative sample of persons aged 50+ years with a comparison sample of younger adults aged 18–49 years.Findings : Analyses included a total of 4,735 participants, with 1,948 (41.1%) males and 2,787 (58.9%) females, of median and mean ages of 58 years and 57.6 (±16.7), respectively. The average annual household expenditures were US$ 1,893.44 (±3,501.14). Older adults had higher expenditure levels at US$ 1,902 (± 3,876), as compared to younger adults, US$ 1,867 (±1,937). Direct health-related costs and food expenditure accounted for 18% and 46% respectively of the total household expenditure of older Ghanaian adults. The prevalence of catastrophic health expenditure among older adults in Ghana was 4.5% (95% CI 3.5% to 5.8%)Conclusion: These updated estimates on household expenditure among older adults provide needed evidence to support the inclusion of social protection mechanisms in the national ageing agenda. The National Health Insurance as presently did not reduce the financial burden for households with older adults.

scholarly journals Household Expenditures And Direct Medical Costs Among Older Adults In Ghana: Evidence From WHO-SAGE Wave 2

2020 ◽  
Author(s):  
Paa-Kwesi Blankson ◽  
Sandra Ama Hewlett ◽  
Thomas Akuetteh Ndanu ◽  
Gyaami Amoah ◽  
Matthew Owusu Boamah ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Expenditure ◽  
Social Protection ◽  
Medical Costs ◽  
World Health ◽  
Household Expenditure ◽  
Financial Risk Protection ◽  
Younger Adults ◽  
Household Expenditures ◽  
Direct Medical Costs

Abstract Background: The Ghanaian population aged 60 years and older will almost double to reach 14% of the total population by 2050. Ascertaining the pattern of health expenditures among this growing population group is important to inform policy makers about the targets for financial risk protection as part of achieving Universal Health Coverage (UHC) by 2030. This study aimed to estimate household expenditures among older adults and determine their direct medical costs.Methods: The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 was conducted in China, Ghana, India, Mexico, Russian Federation, and South Africa between 2014 and 2015, as a follow-up to Wave 0 in 2003 to 2004 and Wave 1 in 2007 to 2010. Survey questions explored sources of income and total directhousehold expenditures in the year preceding the interview. SAGE Ghana was implemented using face-to-face interviews in a nationally representative sample of persons aged 50+ years with a comparison sample of younger adults aged 18–49 years. Findings: Analyses included a total of 4,735 participants, with 1,948 (43.8%) males and 2,787 (56.2%) females, with a mean age of 57.6 (±16.7). The average annual household expenditure was US$ 2,458 (±7,374). Older adults had higher expenditure levels at US$ 2,501 (±8,307), as compared to younger adults, US$ 2,309 (±3,056). Direct health-related and food costs accounted for 10% and 35% respectively of the total household expenditure. The prevalence of catastrophic health expenditure in households of older adults in Ghana was 7.5% (95% CI 6.0% - 9.3%).Conclusion: These updated estimates on household expenditure among older adults provide needed evidence to support the inclusion of social protection mechanisms in the national ageing agenda. The National Health Insurance reduced the burden of direct health expenditure for households with older adults.

scholarly journals The Financial Burden of Tuberculosis for Patients in the Western-Pacific Region

2019 ◽  
Vol 4 (2) ◽  
pp. 94 ◽  
Author(s):  
Kerri Viney ◽  
Tauhidul Islam ◽  
Nguyen Binh Hoa ◽  
Fukushi Morishita ◽  
Knut Lönnroth
Keyword(s):  
Social Protection ◽  
Financial Burden ◽  
The Philippines ◽  
Western Pacific ◽  
World Health ◽  
Pacific Region ◽  
Health Coverage ◽  
Western Pacific Region ◽  
Financial Risk Protection ◽  
The Western Pacific

The End Tuberculosis (TB) Strategy has the ambitious goal of ending the global TB epidemic by the year 2030, which is aligned to the Sustainable Development Goals. One of three high level indicators of the Strategy is the “catastrophic costs” indicator, which aims to determine the proportion of TB-affected households that incur TB-care related costs equivalent to 20% or more of their annual household income. The target is that zero percentage of TB-affected households will incur catastrophic costs related to TB care by the year 2020. In the Western Pacific Region of the World Health Organization, it is a priority to determine the financial burden of TB and then act to mitigate it. To date, eight countries in the Region have conducted nationally representative TB patient cost surveys to determine the costs of TB care. The results from four countries that have completed these surveys (i.e., Fiji, Mongolia, the Philippines, and Vietnam) indicate that between 35% and 70% of TB patients face catastrophic costs related to their TB care. With these results in mind, significant additional efforts are needed to ensure financial risk protection for TB patients, expand Universal Health Coverage, and improve access to social protection interventions. A multi-sectoral approach is necessary to achieve this ambitious goal by the year 2020.

scholarly journals Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

2021 ◽  
pp. 1-23
Author(s):  
Kofi Awuviry-Newton ◽  
Kylie Wales ◽  
Meredith Tavener ◽  
Paul Kowal ◽  
Julie Byles
Keyword(s):  
Older Adults ◽  
Marital Status ◽  
Conceptual Framework ◽  
World Health ◽  
Adult Health ◽  
Care Needs ◽  
Functional Difficulties ◽  
The World ◽  
Health Organization ◽  
Global Ageing

Abstract Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

scholarly journals THE IMPACT OF FUNCTIONAL DISABILITY ON HOSPITALIZATION SPENDING IN SINGAPORE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S837-S837
Author(s):  
Cynthia Chen
Keyword(s):  
Older Adults ◽  
Social Protection ◽  
Functional Disability ◽  
Financial Burden ◽  
Population Data ◽  
Lifestyle Changes ◽  
Health Study ◽  
Singapore Chinese ◽  
Adl Disability ◽  
The Impact

Abstract Singapore is one of the fastest-aging populations due to increased life expectancy and lowered fertility. Lifestyle changes increase the burden of chronic diseases and disability. These have important implications for social protection systems. The goal of this paper is to model future functional disability and healthcare expenditures based on current trends. To project the health, disability and hospitalization spending of future elders, we adapted the Future Elderly Model (FEM) to Singapore. The FEM is a dynamic Markov microsimulation model developed in the US. Our main source of population data was the Singapore Chinese Health Study (SCHS) consisting of 63,000 respondents followed up over three waves from 1993 to 2010. The FEM model enables us to investigate the effects of disability compounded over the lifecycle and hospitalization spending, while adjusting for competing risk of multi-comorbidities. Results indicate that by 2050, 1 in 6 older adults will have at least one ADL disability and 1 in 3 older adults will have at least one IADL disability, an increase from 1 in 12 elders and 1 in 5 elders respectively in 2014. The highest prevalence of functional disability will be in those aged 85 years and above. Lifetime hospitalization spending of elders aged 55 and above is US$24,400 (30.2%) higher among people with functional disability compared to those without disability. Policies that successfully tackle diabetes and promote healthy living may reduce or delay the onset of disability, leading to potential saving. In addition, further technological improvements may reduce the financial burden of disability.

scholarly journals Personality and change in perceived control across the first four months of the coronavirus pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 726-726
Author(s):  
Amanda Sesker ◽  
Ji Hyun Lee ◽  
Martina Luchetti ◽  
Damaris Aschwanden ◽  
Yannick Stephan ◽  
...  
Keyword(s):  
Older Adults ◽  
Personality Traits ◽  
Perceived Control ◽  
Online Survey ◽  
National Sample ◽  
World Health ◽  
Middle Aged ◽  
Younger Adults ◽  
Health Organization ◽  
Over Time

Abstract Objective: This study examined change in perceived control (PC) across the first four months of the global coronavirus pandemic and whether change varied significantly by age and personality traits during the first four months of the pandemic. Methods: Personality was assessed prior to the pandemic in a large national sample of 2,455 American adults (18-100 years) from a preregistered online survey (https://osf.io/q8cpd), first conducted between January 31, 2020 and February 10, 2020. Three additional follow-up waves were conducted: mid-March 2020 (following the World Health Organization declaration of the coronavirus a pandemic), late April 2020 (toward the end of the White House’s 30 Days to Slow the Spread guidance), and late July 2020 (when patient deaths in the U.S. reached 132,918). PC was assessed in Waves 2-4. Results: There were age differences in the trajectory of PC such that PC increase for middle-aged and older adults, whereas younger adults had lower PC and did not increase over the follow-ups. All personality traits but Openness were associated with PC at the first assessment. Conscientiousness, Extraversion, and Agreeableness positively predicted PC change over time. The association between Conscientiousness and Extraversion and increased PC over time was stronger at older ages. Conclusion: Pre-pandemic personality predicted PC and PC change during the first four months of the pandemic, with middle-aged and older adults showing better adaption than younger adults. This study provides new evidence for PC change and associations between personality and PC during the COVID-19 pandemic.

scholarly journals Prevalence, socio-demographic and environmental determinants of asthma in 4621 Ghanaian adults: Evidence from Wave 2 of the World Health Organization’s study on global AGEing and adult health

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243642
Author(s):  
Justice Moses K. Aheto ◽  
Emilia A. Udofia ◽  
Eugene Kallson ◽  
George Mensah ◽  
Minicuci Nadia ◽  
...  
Keyword(s):  
Older Adults ◽  
World Health ◽  
Adult Health ◽  
Environmental Determinants ◽  
Household Level ◽  
Factors Associated ◽  
Household Factors ◽  
Toilet Facility ◽  
Flush Toilet ◽  
Global Ageing

Background A previous multi-site study involving lower- and middle-income countries demonstrated that asthma in older adults is associated with long-term exposure to particulate matter, male gender and smoking. However, variations may occur within individual countries, which are relevant to inform health promoting policies as populations live longer. The present study estimates asthma prevalence and examines the sociodemographic characteristics and environmental determinants associated with asthma in older adults in Ghana. Methods This study utilised data from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2. A final sample of 4621 individuals residing in 3970 households was used in analytical modelling. Factors associated with asthma were investigated using single level and multilevel binary logistic regression models. Results Asthma was reported by 102 (2.2%) respondents. Factors associated with asthma in the univariate model were: those aged 60–69 (OR = 5.22, 95% CI: 1.24, 21.95) and 70 or more (OR = 5.56, 95% CI: 1.33, 23.26) years, Ga-Adangbe dialect group (OR = 1.65, 95% CI: 1.01, 2.71), no religion (OR = 3.59, 95% CI: 1.77, 7.28), having moderate (OR = 1.76, 95% CI: 1.13, 2.75) and bad/very bad (OR = 2.75, 95% CI: 1.58, 4.80) health state, and severe/extreme difficulty with self-care (OR = 3.49, 95% CI: 1.23, 9.88) and non-flush toilet facility (OR = 0.62, 95% CI: 0.39, 0.99). Factors independently associated with asthma in the adjusted models were: those aged 60–69 (OR = 4.49, 95% CI: 1.03, 19.55) years, father with primary education or less (OR = 0.40, 95% CI: 0.17, 0.94), no religion (OR = 2.52, 95% CI: 1.18, 5.41), and households with non-flush toilet facility (OR = 0.58, 95% CI: 0.35, 0.96). Significant residual household-level variation in asthma was observed. Over 40% of variance in asthma episodes could be attributable to residual household-level variations. Conclusion Individual as well as household factors were seen to influence the prevalence of asthma in this national survey. Clinical management of these patients in health facilities should consider household factors in addition to individual level factors.

scholarly journals Perceived Income Adequacy and Well-being Among Older Adults in Six Low- and Middle-Income Countries

2016 ◽  
Vol 74 (3) ◽  
pp. 516-525 ◽  
Author(s):  
Theresa E Gildner ◽  
Melissa A Liebert ◽  
Benjamin D Capistrant ◽  
Catherine D’Este ◽  
J Josh Snodgrass ◽  
...  
Keyword(s):  
Older Adults ◽  
Well Being ◽  
World Health ◽  
Adult Health ◽  
Older Individuals ◽  
Middle Income ◽  
Middle Income Countries ◽  
Income Adequacy ◽  
Perceived Income Adequacy ◽  
Low And Middle Income

Abstract Objectives Perceived income adequacy is positively associated with self-rated health (SRH) and quality of life (QOL) among adults in higher-income countries. Additionally, older individuals often report higher levels of income adequacy. However, it is unclear if these associations, documented primarily in high-income countries, are also evident across economically and culturally distinctive low- and middle-income countries. Methods Data were drawn from the World Health Organization’s Study on global AGEing and adult health (SAGE), a study of adults aged 50 years or older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. Smaller samples of younger adults (18–49 years) were included for comparison purposes. Participants reported income adequacy, SRH, and QOL. Associations between age and income adequacy and between income adequacy and SRH/QOL were examined using country-specific logistic regression analysis. Results Older adults in China and Russia were more likely to report better income adequacy than their 18- to 49-year-old counterparts; however, the opposite was observed in Ghana and India. SRH and QOL improved as income adequacy increased in all countries. Discussion As expected, income adequacy was correlated with SRH and QOL. However, the relationship between age and income adequacy varied cross-culturally, potentially due to differences in familial and governmental financial support.

scholarly journals Food Insecurity Is Associated with Mild Cognitive Impairment among Middle-Aged and Older Adults in South Africa: Findings from a Nationally Representative Survey

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 749 ◽  
Author(s):  
Ai Koyanagi ◽  
Nicola Veronese ◽  
Brendon Stubbs ◽  
Davy Vancampfort ◽  
Andrew Stickley ◽  
...  
Keyword(s):  
South Africa ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Food Insecurity ◽  
Longitudinal Research ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Adult Health ◽  
Cross Sectional

There are no studies on the association between food insecurity and mild cognitive impairment (MCI). Thus, cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in South Africa (2007–2008) were analyzed to assess this association. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted. The sample consisted of 3,672 individuals aged ≥50 years [mean (SD) age 61.4 (18.3); 56% females]. The prevalence of MCI was 8.5%, while 11.0% and 20.8% experienced moderate and severe food insecurity, respectively. After adjustment for potential confounders, moderate and severe food insecurity were associated with 2.82 (95%CI = 1.65–4.84) and 2.51 (95%CI = 1.63–3.87) times higher odds for MCI compared with no food insecurity, respectively. The OR for those aged ≥65 years with severe food insecurity was particularly high (OR = 3.87; 95%CI = 2.20–6.81). In conclusion, food insecurity was strongly associated with MCI among South African older adults. Future longitudinal research is required to assess whether addressing food insecurity may reduce risk of MCI and subsequent dementia.

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