Meta-Analysis the Effect of Chronic Disease on Catastrophic Health Expenditure

ABSTRACT Background: The growing prevalence of chronic diseases contributed to high financial risks of health care. High total out-of-pocket health expenditure relative to income can result in catastrophic health expenditure. This meta-analysis was performed to assess the effect of chronic disease on catastrophic health expenditure. Subjects and Method: Meta-analysis and systematic review was conducted by collecting articles from Google Scholar, PubMed, Springer Link databases, which published from year 2000 to 2020. Keywords to collect the articles including,” chronic disease” OR “chronic illness” AND “catastrophic health expenditure” OR “financial burden” AND “cross sectional” AND “adjusted odds ratio”. The inclusion criteria were full text, in English language, using cross-sectional study design, and reporting adjusted odds ratio. Catastrophic health expenditure criteria if capacity to pay was ≥40% (excluding primary needs). The study population was households. The intervention was chronic disease with comparison non chronic disease. The study outcome was catastrophic health expenditure. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using Revman 5.3. Results: 9 studies from Tanzania, Korea, China, Ghana, and India were selected for this study. This study showed that chronic disease increased catastrophic health expenditure (aOR= 1.94; 95% CI= 1.45 to 2.54; p<0.001). Conclusion: Chronic disease increases catastrophic health expenditure. Keywords: chronic disease, catastrophic health expenditure Correspondence: Yeny Ristaning Belawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57216, Central Java. Email: [email protected]. Mobile: 082243302740. DOI: https://doi.org/10.26911/the7thicph.04.49

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Epidemiology of hypertension in selected towns of Wollega zones, Western Ethiopia, 2019: A community-based cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211024519 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110245

Author(s):

Getu Mosisa ◽

Bikila Regassa ◽

Bayise Biru

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Alcohol Consumption ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Community Based ◽

Cross Sectional

Introduction: Hypertension remains an emerging public health problem globally, particularly in developing countries. Age, income level, obesity, alcohol consumption, smoking, vegetables and fruit consumption, physical activity and chat chewing were some risk factors of hypertension. However, there are limited data on the epidemiology of hypertension in Ethiopia. This study aimed to assess Epidemiology of Hypertension among the community of selected towns of Wollega zones. Methods: A community-based cross-sectional study was conducted from 1 to 30 June 2019 in selected towns of Wollega zones. A multistage sampling technique was used to select 840 study participants. Data were collected using the WHO STEP wise approach. The data were coded and entered into EpiData 3, and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regression analyses were conducted. Statistical significance was declared at p-value < 0.05. Results: The study included a total of 838 respondents with a response rate of 99.7%. The prevalence of hypertension was found to be 189 (22.6%) (95% confidence interval = 19.9%–25.2%). Of this, 108 (12.9%) and 81 (9.7%) of female and male were hypertensive, respectively. Age groups of 30–44 years (adjusted odds ratio = 2.65 (1.43, 4.89)), 45–59 years (adjusted odds ratio = 3.55 (1.79, 7.04)), above 60 years (adjusted odds ratio = 2.97 (1.43, 6.18)), having history of alcohol consumption (adjusted odds ratio = 4.29 (2.4, 7.66)), involving in vigorous physical activity (adjusted odds ratio = 0.096 (0.028, 0.33)), not walking to and from the work (adjusted odds ratio = 13.12 (8.34, 20.67)), being overweight (adjusted odds ratio = 1.98 (1.21, 3.25)), inadequate fruits serving per day (adjusted odds ratio = 2.93 (1.75, 4.88)) were significantly associated with hypertension. Conclusion: The prevalence of hypertension was found to be high in the study area. Older age, alcohol consumption, not engaging in vigorous activity, physical inactivity, being overweight and inadequate intake of fruits were found to be risk factors for hypertension. Therefore, health care providers should provide extensive health education and promotion on recommended lifestyle modification to tackle the burden of hypertension.

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Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312121989497 ◽

2021 ◽

Vol 9 ◽

pp. 205031212198949

Author(s):

Cylia Nkechi Iweama ◽

Olaoluwa Samson Agbaje ◽

Prince Christian Ifeanachor Umoke ◽

Chima Charles Igbokwe ◽

Eyuche Lawretta Ozoemena ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medication Nonadherence ◽

Cross Sectional ◽

Tuberculosis Patients ◽

North West ◽

Short Course ◽

Directly Observed Treatment

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

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Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312120978008 ◽

2020 ◽

Vol 8 ◽

pp. 205031212097800

Author(s):

Damtew Asrat ◽

Atsede Alle ◽

Bekalu Kebede ◽

Bekalu Dessie

Keyword(s):

Confidence Interval ◽

Traditional Medicine ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medicine Use ◽

Community Based ◽

Cross Sectional ◽

Traditional Medicines ◽

Factors Associated

Background: Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda. Method: Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables. Results: Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children. Conclusions: Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.

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Prevalence and associated factors of diarrhea among under-five children in Debre Berhan Town, Ethiopia 2018: A cross sectional study

10.21203/rs.2.13141/v3 ◽

2020 ◽

Author(s):

Sisay Shine ◽

Sindew Muhamud ◽

Solomon Adnew ◽

Alebachew Demelash ◽

Makda Abate

Keyword(s):

Low Income ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Major Public Health Problem ◽

Sectional Study ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Debre Berhan

Abstract Background: Diarrhea is responsible for 525,000 children under-five deaths and 1.7 billion cases globally and is the second leading cause of death among children under-five every year. It is a major public health problem in low income countries like Ethiopia. The main aim of this study was to assess the prevalence of diarrhea and associated risk factors among children under-five in Debre Berhan Town, Ethiopia. Methods: A community-based cross-sectional study was conducted in 420 parent or caretaker/children pairs in Debre Berhan town between 13–18 April 2018. A multi-stage sampling strategy was used to select the study participants. Data were collected using pre-tested and structured questionnaires. Data were entered in Epi-info computer software version 3.5.1 and exported to SPSS Window Version-16 for analysis. Adjusted odds ratio with 95% confidence intervals were used to assess the level of significance. Results: The two week prevalence of diarrhea among children under-five was 16.4% (69/351). Children aged 7-11 months (adjusted odds ratio (AOR): 4.2, 95% confidence interval (CI): 1.2 - 15.3), being the second-born child (AOR: 3.9, 95%CI: 1.8 - 8.5), not vaccinated against rotavirus (AOR: 10.3, 95%CI: 3.2 - 91.3) and feeding children by hand (AOR: 2.5, 95%CI: 1.1 - 6.1) were significant predictors of diarrhea. Conclusions: This study revealed that the two weeks period prevalence of diarrhea among children under-five years was 16.4%. Education programs on the importance of vaccination against rotavirus, increasing breast feeding frequency with complementary food after six months and the critical points of hand washing are recommended.

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The association of gout with an increased risk of hypertension and diabetes mellitus among stroke survivors in New Zealand: A cross-sectional study using routinely collected electronic health data

JRSM Cardiovascular Disease ◽

10.1177/2048004019863239 ◽

2019 ◽

Vol 8 ◽

pp. 204800401986323 ◽

Cited By ~ 2

Author(s):

Dina Eufemia D San Gabriel ◽

Julia Slark

Keyword(s):

Diabetes Mellitus ◽

New Zealand ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Stroke Survivors ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.

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Relationship between Periodontitis and Glaucoma: A Cross-Sectional Study

Journal of Ophthalmology ◽

10.1155/2020/5384602 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Soo Hwan Byun ◽

Dae Myoung Yoo ◽

Minwook Chang ◽

Hyo Geun Choi ◽

Seok Jin Hong

Keyword(s):

Odds Ratio ◽

Adjusted Odds Ratio ◽

Epidemiological Data ◽

Cross Sectional Study ◽

Sectional Study ◽

Epidemiology Study ◽

Chi Square ◽

Cross Sectional ◽

History Of ◽

And Control

The objective of this cross-sectional study was to evaluate the association between periodontitis and glaucoma. This prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study performed between 2004 and 2016. Among 173,209 participants, 9572 patients with periodontitis and 115,332 controls (nonperiodontitis) were selected. We analysed the history of glaucoma in periodontitis and control participants. The participants were interviewed regarding their history of hypertension, diabetes mellitus, hyperlipidaemia, periodontitis, glaucoma, smoking, and alcohol consumption by trained interviewers. A logistic regression model was created to analyse the odds ratio of having a history of glaucoma among patients with periodontitis. Two-tailed analyses using chi-square and independent t-tests were used for statistical analysis. The adjusted odds ratio of periodontitis as a risk factor for glaucoma was 3.44 (95% confidence interval = 2.99–3.97, p < 0.001 ). This study demonstrated that glaucoma was associated with periodontitis.

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Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023033 ◽

2019 ◽

Vol 9 (5) ◽

pp. e023033 ◽

Cited By ~ 4

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Xiao Wang ◽

Xin Lan ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Economic Status ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

Urban China ◽

Shaanxi Province ◽

Vulnerable Groups ◽

Cross Sectional

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

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Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study

10.21203/rs.2.14202/v3 ◽

2020 ◽

Author(s):

Umesh Ghimire ◽

Binod Kumar Aryal ◽

Ankush Kumar Gupta ◽

Suman Sapkota Sapkota

Keyword(s):

Odds Ratio ◽

Food Access ◽

Adjusted Odds Ratio ◽

Severe Acute Malnutrition ◽

Cross Sectional Study ◽

Acute Malnutrition ◽

Sectional Study ◽

Cross Sectional ◽

Household Food ◽

Nutritional Status Of Children

Abstract Background: Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centres (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as significant. Results: Out of 398 children, 5.8 percent were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months). . Conclusions: The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.

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The Financial Burden of Catastrophic Health Expenditure on Households with Chronic Diseases: Financial Ratio Analysis

10.21203/rs.3.rs-569897/v1 ◽

2021 ◽

Author(s):

Hyunwoo Jung ◽

Young Dae Kwon ◽

Jin-Won Noh

Keyword(s):

Chronic Disease ◽

Health Expenditure ◽

Financial Burden ◽

Catastrophic Health Expenditure ◽

Financial Strain ◽

Income Loss ◽

Absolute Size ◽

Financial Ratio ◽

Financial Ratio Analysis ◽

Indicator Liquid

Abstract Background: The financial status of households is vulnerable to chronic disease related to high medical expenses and income loss; The financial strain could be assessed by the five indicators. household surplus indicator, liquid asset/debt ratio, solvency indicator, and liquidity indicator.Purpose: We investigated the association between catastrophic health expenditure (CHE) and financial ratio indicators in households with chronic disease in South Korea. Methodology: To determine the financial strain, thresholds were applied to the financial ratios. We conducted multiple logistic regression to figure out whether CHE is associated with financial strain. Furthermore, we analyzed the effect of CHE on absolute finance size, which is basic financial indicators, by multiple linear regression.Results: When CHE occurred, all of the financial ratio indicators deteriorated. However, it was not due to decreases in the absolute size of wealth, income, but rather the relative balance between finances. Especially, the loss of the liquid assets was the major factor of deterioration. Also, all types of labor-related income deteriorated. Only the private transfer income increased.Conclusion: This study revealed that CHE in households with chronic disease negatively impacts the household's finances. It turned out that the financial coping strategies are only resource-consuming.

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Association between Geriatric Nutrition Risk Index and The Presence of Sarcopenia in People with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Nutrients ◽

10.3390/nu13113729 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3729

Author(s):

Fuyuko Takahashi ◽

Yoshitaka Hashimoto ◽

Ayumi Kaji ◽

Ryosuke Sakai ◽

Yuka Kawate ◽

...

Keyword(s):

Odds Ratio ◽

Skeletal Muscle Mass ◽

Adjusted Odds Ratio ◽

Handgrip Strength ◽

Risk Index ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Skeletal Muscle Mass Index

The aim of this cross-sectional study was to examine the association between the geriatric nutritional risk index (GNRI) and the prevalence of sarcopenia in people with type 2 diabetes (T2DM). Having both low handgrip strength (<28 kg for men and <18 kg for women) and low skeletal muscle mass index (<7.0 kg/m2 for men and <5.7 kg/m2 for women) was diagnosed as sarcopenia. GNRI was estimated by the formula as below: GNRI = (1.489 × serum albumin level [g/L]) + (41.7 × [current body weight (kg)/ideal body weight (kg)]). Participants were dichotomized on the basis of their GNRI scores (GNRI < 98, low; or GNRI ≥ 98, high). Among 526 people (301 men and 225 women) with T2DM, the proportions of participants with sarcopenia and low GNRI were 12.7% (n = 67/526) and 5.1% (n = 27/526), respectively. The proportion of sarcopenia in participants with low-GNRI was higher than that with high GNRI (44.4% [n = 12/27] vs. 11.0% [n = 55/499], p < 0.001). The GNRI showed positive correlations with handgrip strength (r = 0.232, p < 0.001) and skeletal muscle mass index (r = 0.514, p < 0.001). Moreover, low GNRI was related to the prevalence of sarcopenia (adjusted odds ratio, 4.88 [95% confidence interval: 1.88–12.7], p = 0.001). The GNRI, as a continuous variable, was also related to the prevalence of sarcopenia (adjusted odds ratio, 0.89 [95% confidence interval: 0.86–0.93], p < 0.001). The present study revealed that low GNRI was related to the prevalence of sarcopenia.

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