scholarly journals The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran

2015 ◽  
Vol 40 (2) ◽  
pp. 58-62 ◽  
Author(s):  
M Khammarnia ◽  
A Keshtkaran ◽  
Z Kavosi ◽  
R Hayati
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Expenditure ◽  
Health Spending ◽  
Poverty Line ◽  
World Health ◽  
Cluster Sampling ◽  
World Health Survey ◽  
Study Results

The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071±0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p<0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p<0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.Bangladesh Med Res Counc Bull 2014; 40 (2): 58-62

scholarly journals Catastrophic health expenditure: the case of households with adults over 60 years of age in Peru – 2019

2021 ◽  
Vol 25 (111) ◽  
pp. 191-200
Author(s):  
Mario Villegas Yarleque ◽  
Freddy Carrasco Choque ◽  
Ronald Hidalgo Armestar ◽  
Gretel Fiorella Villegas Aguilar
Keyword(s):  
Health Insurance ◽  
World Health Organization ◽  
Urban Areas ◽  
Health Sector ◽  
Health Spending ◽  
Household Survey ◽  
World Health ◽  
Academic Degree ◽  
Health Organization ◽  
Catastrophic Spending

Within the health sector, it is vitally important to analyze whether households incur catastrophic spending for using such services. In this sense, the study seeks to estimate catastrophic health spending for households with members over 60 years of age. To achieve the objective, the methodology of the World Health Organization was used to find the way in which the household incurs in catastrophic spending, using as an instrument the National Household Survey of Peru, for the year 2019. The main results found were: that families living in urban areas, who have health insurance, who have a higher academic degree, decrease the probability of incurring in catastrophic spending, while being over 60 years old, having a chronic disease, suffering some permanent limitation and not having hygienic services, help to incur in catastrophic spending, so it was concluded that the most vulnerable areas should be attended to achieve a better welfare for older adults. Keywords: catastrophic expense, out-of-pocket expense, health insurance. References [1]J. Alvis, c. Marruco, N. Alvis, F. Gomes, Á. Flores and D. Moreno, «Gasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia,» Salud Publica, 10 2018. [2]E. Giménez, L. Flores, J. Rodriguez, G. Ocampos and N. Peralta, «Gastos catastróficos de salud en los hogares del Paraguay,» Instituto de Investigaciones en Ciencias de la Salud, vol. 16, nº 2, 2018. [3]E. Gonzáles and J. García, «Gastos catastróficos en salud, transferencias gubernamentales y remesas en México, » Papeles de población, vol. 23, nº 91, 2017.[4]A. Hernández, C. Rojas, M. Santero, J. Prado y D.Rosselli, «health-related out-of-pocket expenses in older peruvian adults: analysis of the national householdsurvey on living conditions and poverty 2017,» Rev Peru Med Exp Salud Publica, vol. 35, nº 3, 2017. [5]O. Lazo, J. Alcalde and O. Espinosa, «El sistema de salud en Perú,» Lima , 2016. [6]World Health Organization Geneva, «Distribución del gasto en salud y gastos catastróficos Metodología,» 2005. [7]Organización Mundial de la Salud, «Organización Mundial de la Salud,» 2014. [Online]. Available: https://www.who.int/topics/chronic_diseases/es/. [8]Organización Mundial de la Salud , «Organización Mundial de la Salud,» 2018. [Online]. Available: https://www.who.int/topics/disabilities/es/.  

scholarly journals Comparative study to determine self-medication practice and pattern in urban and rural areas of Etawah district

2019 ◽  
Vol 7 (1) ◽  
pp. 216
Author(s):  
Nishant Singh ◽  
Naresh Pal Singh ◽  
Pankaj Kumar Jain ◽  
Vaibhav Singh ◽  
Shailendra Chaurasiya ◽  
...  
Keyword(s):  
Rural Area ◽  
Rural Areas ◽  
Urban Areas ◽  
Nuclear Family ◽  
World Health ◽  
Common Reason ◽  
Cluster Sampling ◽  
Age Group ◽  
Self Medication ◽  
Urban And Rural Areas

Background: According to William Osler, a great feature which distinguishes man from animals is the desire to take medicine. Self-medication is an age old practice. According to World Health Organization guidelines “self-medication is defined as use of medicinal products by the individuals to treat self-recognized disorders or symptoms, or the intermittent or continuous use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.Methods: It was a cross sectional study, which was conducted among residents of urban and rural areas of Etawah district, Uttar Pradesh by using 40×5 cluster sampling. The data was collected by using pre designed, semi-structured questionnaire. Proforma included socio- demographic profile, practice of self- medication and pattern of self-medication.Results: Most of the participants who indulged in self-medication in urban areas 69.5% and rural areas 65% belong to the age group 20-39 years. Majority of the participants (51.0%) in urban areas belonged to the nuclear family while most of the participants (50%) belonged to joint family followed by nuclear family (40%) in rural areas. most common reason for self-medication in urban area was the availability of old prescription which is present in 30.0% (60) of subjects but in rural area most common reason for self-medication was high fee of doctor which was 29.0% (58).Conclusions: Most common age group indulged in self-medication was 20-39 years. Most common reason for self-medication was availability of old prescription at home while in rural area, high fees of doctor was the common reason for self-medication.

scholarly journals Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1–3

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244807
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna C. Russell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
World Health ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Significant Difference ◽  
Survey Instruments

The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11–12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants’ BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.

scholarly journals Assessing medical impoverishment and associated factors in health care in Ethiopia

2019 ◽  
Author(s):  
Amarech Guda Obse ◽  
John E. Ataguba
Keyword(s):  
Rural Areas ◽  
Health Expenditure ◽  
Formal Education ◽  
Significant Proportion ◽  
Health Spending ◽  
Poverty Line ◽  
Sub Saharan Africa ◽  
Financial Protection ◽  
Health Coverage ◽  
Current Health

Abstract Background About 5% of the global population, predominantly in low-and-middle income countries, is forced into poverty because of out-of-pocket (OOP) health spending. In most countries in sub-Saharan Africa, the share of OOP health spending in current health expenditure exceeds 35%, increasing the likelihood of impoverishment. In Ethiopia, OOP payments remained high at 37% of current health expenditure in 2016. This study aims to assess impoverishment resulting from OOP health spending in Ethiopia, and examine the factors associated with this impoverishment. Methods This paper uses data from the Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11. The HCES covered 10,368 rural and 17,664 urban households. OOP health spending includes spending on various out-patient and inpatient services. Impoverishing impact of OOP health spending was estimated by comparing poverty estimates before and after OOP health spending. A probit model was used to assess factors that are associated with impoverishment. Results Using the Ethiopian national poverty line of Birr 3,781 per person per year (equivalent to US$2.10 per day), OOP health spending pushed about 1.19% of the population (i.e. over 877,000 individuals) into poverty. Living in rural areas (highland, moderate, or lowland) increased the likelihood of impoverishment compared to an urban residence. On the other hand, the households headed by males, and adults with a formal education decreased the likelihood of impoverishment, compared to their counterparts. Conclusion In Ethiopia, OOP health spending impoverishes a significant number of the population. Although the country had piloted and initiated many reforms, e.g. the fee waiver system and community-based health insurance, a significant proportion of the population still lack financial protection. More is required to provide financial protection to achieve universal health coverage in Ethiopia, where the informal sector is relatively large.

scholarly journals Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 404
Author(s):  
Alejandro José Casanova-Rosado ◽  
Juan Fernando Casanova-Rosado ◽  
Mirna Minaya-Sánchez ◽  
José Luís Robles-Minaya ◽  
Juan Alejandro Casanova-Sarmiento ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
Mental Disorders ◽  
Chronic Diseases ◽  
Population Based ◽  
Self Report ◽  
World Health ◽  
Complex Nature ◽  
Cluster Sampling ◽  
World Health Survey ◽  
Cross Sectional

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

scholarly journals Salt intake and blood pressure in Iranian children and adolescents: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Salt Intake ◽  
Daily Intake ◽  
Population Based ◽  
World Health ◽  
Second Phase ◽  
Salt Consumption ◽  
The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

scholarly journals Risk factor assessment and screening for diabetes in field practice area of a private medical college in Thiruvallur district of Tamil Nadu

2017 ◽  
Vol 4 (8) ◽  
pp. 2670 ◽  
Author(s):  
Sathish Dev ◽  
Timsi Jain ◽  
Sivaprakasam P. ◽  
Dinesh Raja
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Tamil Nadu ◽  
Univariate Analysis ◽  
The Elderly ◽  
World Health ◽  
Chi Square ◽  
Medical College ◽  
Diabetes Status ◽  
Field Practice

Background: Diabetes, which was known to be an epidemic in the urban areas, has been found to be increasing rapidly in the rural areas too as a result of the socioeconomic transitions. Diabetes is no longer only a disease of the elderly but is one of the major causes of morbidity and mortality affecting youth and middle aged people.Methods: Screening camp for diabetes was conducted by the Department of Community Medicine in three different areas in the field practice area of Saveetha Medical College and Hospital viz. Thirumazhisai, Kuthambakkam and Velavedu in Thiruvallur district of Tamil Nadu on 7th April 2016 as a part of World Health Day 2016 celebration. Data was collected using a predesigned interview schedule. Descriptive statistics was calculated using rates, ratios & proportions. Univariate analysis was done using Chi square test to find the association between various factors and diabetes status. A parsimonious regression model was developed to find the predictor variables for diabetes.Results: A total of 188 people aged above 18 years attended the screening camps. Majority of the camp attendees were females (62.2%). Proportion of people having diabetes (already diagnosed plus newly screened) was found to be 18.1% out of which 3.2% were screened positive for diabetes. On regression analysis, Intake of alcohol and perceived stress were found to be significantly associated with diabetes (p<0.05).Conclusions: This study highlights a significant burden of undiagnosed cases of diabetes in the community. This indicates the need for systematic screening and awareness programs to identify the undiagnosed cases in the community and offer early life style modifications, treatment and regular follow up to such individuals.

scholarly journals Evaluation of Midwifery Care Standard Policy BPJS Health Participants

2020 ◽  
Vol 7 (2) ◽  
pp. 172-184
Author(s):  
Astri Nurdiana ◽  
Ella Nurlailasari
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Midwifery Care ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Standard Rate ◽  
Urban And Rural Areas

Enforcement of national health insurance organized through Badan Penyelenggara Jaminan Kesehatan (BPJS) experiences various polemics, one of which relates to financing for midwifery care listed in Permenkes No. 52 of 2016 concerning health service fare standards in the health insurance program, whether the standard rate can cover the needs of services provided by midwives in rural or urban areas or not. The result found that there is no difference in midwifery care fare between urban and rural areas (p>0.05), but there are differences in midwifery care fare between rural and BPJS fare standard (p<0.05) and between urban fare and BPJS fare standard (p< 0.05)

scholarly journals Mental health survey of the adult population in Iran

2004 ◽  
Vol 184 (1) ◽  
pp. 70-73 ◽  
Author(s):  
A. A. Noorbala ◽  
S. A. Bagheri Yazdi ◽  
M. T. Yasamy ◽  
K. Mohammad
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Learning Disability ◽  
Rural Areas ◽  
Urban Areas ◽  
Adult Population ◽  
General Health Questionnaire ◽  
Population Sample ◽  
Cluster Sampling ◽  
International Studies

BackgroundNo national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention.AimsTo determine the mental health status of a population sample aged 15 years and over.MethodThrough random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability (‘mental retardation’), epilepsy and psychosis.ResultsAbout a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.33% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people.ConclusionsPrevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.

scholarly journals Did expansion of health insurance coverage reduce horizontal inequity in healthcare finance? A decomposition analysis for China

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025184
Author(s):  
Zhonghua Wang ◽  
Xue Zhou ◽  
Yukuan Gao ◽  
Mingsheng Chen ◽  
Andrew J Palmer ◽  
...  
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Decomposition Analysis ◽  
Healthcare Financing ◽  
Horizontal Inequity ◽  
Financing System ◽  
Percentage Points ◽  
Out Of Pocket Payments ◽  
Healthcare Finance

Objectives‘Horizontal inequity’ in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 through two rounds of national household health surveys.DesignTwo rounds of cross-sectional study.SettingHeilongjiang Province, China.ParticipantsAdopting a multistage stratified random sampling, 3841 households with 11 572 individuals in 2003 and 5530 households with 15 817 individuals in 2008 were selected.MethodsThe decomposition method of Aronsonet alwas used in the present study to measure the redistributive effects and horizontal inequity in healthcare finance.FindingsOver the period 2002–2007, the absolute value of horizontal inequity in total healthcare payments decreased from 93.85 percentage points to 35.50 percentage points in urban areas, and from 113.19 percentage points to 37.12 percentage points in rural areas. For public health insurance, it increased from 17.84 percentage points to 28.02 percentage points in urban areas, and decreased from 127.93 percentage points to 0.36 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 79.92 percentage points to 24.83 percentage points in urban areas, and from 127.71 percentage points to 53.10 percentage points in rural areas.ConclusionsOur results show that horizontal inequity in total healthcare financing decreased over the period 2002–2007 in China. In addition, out-of-pocket payments contributed most to the extent of horizontal inequity, which were reduced both in urban and rural areas over the period 2002–2007.

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