scholarly journals Hospitalization Expenditures and Out-Of-Pocket Expenses in Patients With Stroke in Northeast China, 2015–2017: A Pooled Cross-Sectional Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zihua Ma ◽  
Gongman Deng ◽  
Zhaolin Meng ◽  
Huazhang Wu
Keyword(s):  
Economic Burden ◽  
Northeast China ◽  
Social Economic ◽  
Financial Burden ◽  
Social Groups ◽  
Liaoning Province ◽  
Hospitalization Costs ◽  
The Mean ◽  
The Individual ◽  
Heavy Financial Burden

Background: Stroke is the second most common cause of mortality worldwide and the leading cause of death in China. It imposes a heavy financial burden on patients, especially for some social groups that are vulnerable to economic risks.Objective: This study aimed to comprehensively assess the magnitude of hospital and out-of-pocket (OOP) costs associated with stroke in Northeast China.Methods: Patients were selected via a multistage stratified cluster random sampling approach. We reviewed all patients’ records from 39 hospitals across six cities in Liaoning Province between 2015 and 2017. Cost characteristics of four major stroke types were analyzed. Multivariate linear regression analyses were employed to examine the determinants of hospitalization costs and OOP expenses.Results: A total of 138,757 patients were assessed for the medical costs. The mean hospitalization costs were $1,627, while the mean OOP expenses were $691, accounting for 42.5% of the total expenditures. Medication expenses were the largest contributor to hospitalization costs. The regression analysis suggested that age, length of stay (LOS), social identity, type of stroke, surgery, intensive care unit (ICU) admission, hospital level and hospital type were significantly correlated with hospitalization costs and OOP expenses.Conclusion: Stroke imposes a heavy financial burden on both patients and society in Liaoning Province, Northeast China. Results showed that there are some differences in the individual and social economic burden among different types of stroke. In addition, stroke patients share a high proportion of costs through OOP expenses, especially for poor social-economic status patients. Targeted intervention measures and specific policies are needed to reduce the individual and social economic burden of stroke as well as improve equity in health care among different social groups.

scholarly journals Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study

Health Scope ◽  
2022 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maryam Shirvani Shiri ◽  
Sara Emamgholipour ◽  
Rajabali Daroudi ◽  
Maryam Tatary ◽  
Zohreh Kazemi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Influencing Factors ◽  
Financial Burden ◽  
First Grade ◽  
Ischemic Heart ◽  
Icu Admission ◽  
Medical Supplies ◽  
Hospitalization Costs ◽  
The Mean

Background: Ischemic heart disease (IHD) is the leading cause of death and disability worldwide and in Iran, which imposes a heavy financial burden both on patient’s family and society. Objectives: This study aimed to analyze the direct medical costs of inpatients with IHD and its influencing factors in Iran in 2020. Methods: The sample of this cross-sectional study included 41,357 patients with IHD selected from the hospital information system (HIS) of the Iran Health Insurance Organization from August 23, 2019, to June 20, 2020. The study used the claims data of these patients, which included their demographics, length of stay (LOS), intensive care unit (ICU) admission, hospital accreditation grade, hospital ownership type, and patient discharge status. The multiple linear regression model was employed to evaluate the relationship between hospitalization costs and the associated factors. All statistical tests were conducted at the significance level of P < 0.05 using the R 3.6.3 software. Results: The mean age of patients was 63.95 ± 12.63 years old, and most of them were male (54.4%). The mean hospitalization cost per patient and per day was 586.42 ± 472.51 USD and 103.64 ± 100.29 USD, respectively. Moreover, the mean LOS was 4.92 days. Drugs and consumable medical supplies, as well as nursing and hoteling services, had the highest shares of hospitalization costs (29.54% and 29.4%, respectively). The hospitalization costs of patients with IHD were higher among men (β = 1.24), age 61 - 70 years (β = 1.38), LOS ≥ 5 (β = 2.92), ICU admission (β = 1.62), Iranian health fund (β = 1.21), and private hospitals (β = 1.91). Top-grade and first-grade hospitals had higher costs compared to grade 2 (β = 0.67), grade 3 (β = 0.35), and grade 4 (β = 0.72) hospitals. Deceased patients had also higher costs than patients with complete recovery (β = 0.63), relative recovery (β = 0.59), follow-up (β = 0.51), transfer to other medical centers (β = 0.44), and discharge against medical advice (DAMA) (β = 0.62). Conclusions: According to the results, shortening the LOS and controlling the high costs of drugs and consumable medical supplies are among the main strategies to reduce high hospitalization costs.

scholarly journals Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036892
Author(s):  
Lelisa Fekadu Assebe ◽  
Eyerusalem Kebede Negussie ◽  
Abdulrahman Jbaily ◽  
Mieraf Taddesse Taddesse Tolla ◽  
Kjell Arne Johansson
Keyword(s):  
Indirect Cost ◽  
Economic Burden ◽  
Financial Burden ◽  
Household Survey ◽  
Income Quintile ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures ◽  
The Mean ◽  
Substantial Economic Burden

ObjectivesHIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia.DesignA cross-sectional survey.Setting27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV.ParticipantsA total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively.Outcome measuresThe economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold.ResultsThe mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p<0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p<0.001). This figure was higher for drug-resistant TB (62%).ConclusionsHIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.

scholarly journals Infectious illnesses of young children: financial burden for rich countries - a literature review

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
J Graichen
Keyword(s):  
Cost Of Illness ◽  
Economic Burden ◽  
Financial Burden ◽  
Well Being ◽  
Kindergarten Children ◽  
Female Employment ◽  
Efficient Design ◽  
Positive Effects ◽  
Hospitalization Costs ◽  
Cost Efficient

Abstract   While childcare assistance has indisputable positive effects on female employment and economic growth, children attending day care centres show a considerably higher number of infections compared to those raised at home. This is not only a substantial threat to the well-being of families, but also a major economic burden for society. This review aims at examining studies that describe and quantify the costs of illnesses that are possibly transmitted in kindergarten to enable development of policies and interventions. A scientific literature search was performed. The electronic databases PubMed and Medline were searched with keywords and MeSH terms (Cost of Illness; Health Care Costs; Child). Articles were considered relevant, if published after the year 2000 in English, if conducted in Europe, USA or Australia, examining contagious illnesses (respiratory, influenza(-like), gastrointestinal diseases) of children and if not solely focused on hospitalization costs. A total of 504 records were identified. After abstract and full text screening, 15 articles were selected. No article summarizes all illnesses that are possibly transmitted in kindergarten, studies rather estimate costs for one diagnosis or one symptom group only. Main cost buckets considered are direct medical, direct non-medical and indirect costs (mainly due to loss of workdays of caregivers). Focus and perspective of the studies and thus the quantification of costs differs widely (e.g., for respiratory illnesses per non-hospitalized case one study claims 123 vs. 49 Euro in neighbouring countries). Existing cost of illness studies cannot easily be combined to one overall cost estimation for sick kindergarten children, which is needed to foster public health actions and to enable cost-efficient design. However, solely looking at single illnesses already reveals the big potential which comes with reducing contagious illnesses in the child age and thus, the urgent need to action to relieve children and society. Key messages The economic burden arising from contagious illnesses among kindergarten children is substantial and reveals the need for policies and interventions to relieve children and society. Further research is needed to get a comprehensive view of cost of illnesses for children with illnesses transmitted in kindergarten to enable cost-efficient design of interventions.

scholarly journals Effects of hearing aid on improving cognition and depressive symptoms in elderly

2021 ◽  
Vol 7 (4) ◽  
pp. 639
Author(s):  
K. J. Arun Kumar ◽  
M. Vidyalakshmi
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Negative Impact ◽  
Hearing Aid ◽  
Financial Burden ◽  
Hearing Aid Use ◽  
The Mean ◽  
The Individual

<p class="abstract"><strong>Background: </strong>The prevalence of dementia among people aged over 60 years is between 5–7%, with the numbers of those affected globally predicted to double every 20 years between 2010 and 2050. While cognitive impairment and dementia have a negative impact on the individual, caregivers and society, the financial burden of cognitive decline and dementia are also a major source of concern. However, there is some cause for optimism in the form of potentially modifiable risk factors which can prevent or delay dementia. In this study we investigate the effect of hearing aid on improving cognition and depressive symptoms in elderly individuals with hearing impairment.</p><p class="abstract"><strong>Methods: </strong>Patients with hearing impairment were selected based on inclusion and exclusion criteria and prescribed with similar type of hearing aid. MMSE and GDS scores were obtained before fitting hearing aid and 3 months after fitting hearing aid.</p><p class="abstract"><strong>Results: </strong>A<strong> </strong>total number of 66 patients, 40 males (61%) and 26 females (39%) were included in the study. Before using hearing aids, the mean MMSE score was 18.98±5.37 (range 10–26), and it increased to 21.08±4.77 (range 12–27) after 3 months of hearing aid use (p&lt;0.005). The GDS analysis revealed a mean score of 6.85±2.81 (range 3–11) before using hearing aid and it decreased to 5.44±1.82 (range 3–8 after using the hearing aid (p&lt;0.005).</p><p class="abstract"><strong>Conclusions: </strong>Treating hearing loss with hearing aid may reduce burden associated with cognitive decline and depression.</p><p class="abstract"> </p>

scholarly journals Prevalence and factors contributing to dental caries in 12–15-year-old school adolescents in northeast China

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e044758
Author(s):  
Jian Li ◽  
Kaiqiang Zhang ◽  
Zhenfu Lu
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Northeast China ◽  
Dental Health ◽  
Age Groups ◽  
Liaoning Province ◽  
Permanent Teeth ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Mean

ObjectivesThe present study investigated the prevalence and factors contributing to dental caries in 12–15-year-old adolescents in northeast China to provide information for dental caries promotion programmes.Design, setting and participantsA cross-sectional survey including caries examination and questionnaire was performed in Liaoning province, China. 3731 12–15-year-old school adolescents participated in the survey. School adolescents were randomly selected and received a clinical oral examination and completed questionnaires that assessed their oral health-related behaviours and attitudes.ResultsOverall, 3731 12–15-year-old school adolescents participated in the survey. The prevalence of dental caries in these adolescents was 53.65%, and the mean number of decayed–missing–filled teeth (DMFT) in the adolescents was 1.64±2.38 in northeast China, which was higher than the mean in China as a whole. A remarkable difference in DMFTwas exhibited between age groups, region and gender (p<0.05). Logistic regression analysis showed that age, region, gender and father’ education were related to the occurrence of caries in these adolescents.ConclusionThe 12–15-year-old school adolescents assessed exhibited a high prevalence of dental caries and low awareness of oral health. It is critical to protect permanent teeth, and oral and dental health education and promotion should be more comprehensively integrated into school courses for these adolescents.

scholarly journals Direct medical costs of hospitalized patients with idiopathic pulmonary fibrosis in China

2019 ◽  
Author(s):  
Xiaofen Zheng ◽  
Bingbing Xie ◽  
Yan Liu ◽  
Ming Zhu ◽  
Shu Zhang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Economic Burden ◽  
Medical Costs ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
Direct Medical Costs ◽  
Hospitalization Costs ◽  
The Mean

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause. The incidence of IPF is increasing year by year, as well as the mortality rates, which is really a burden both for the family and the society. However few data concerning the economic burden of the patients with IPF is available, especially in China.ObjectiveThis study aimed to examine the direct medical costs of hospitalized patients with IPF and to determine the contributing factors.MethodsThis retrospective analysis used the cost-of-illness framework in order to analyze the direct medical costs of patients with IPF. The study used data from the pneumology department of Beijing Chao-Yang Hospital affiliated to Capital Medical University from year 2012 to 2015. The direct medical costs included drug fee, auxiliary examination fee, treatment fee and other fee. Patients’ characteristics, medical treatment, and the direct medical costs were analyzed by descriptive statistics and multivariable regression.ResultsThere were 219 hospitalized patients meeting the diagnosis of IPF, 91% male. The mean age was 65 years old. For the direct medical costs of hospitalized patients with IPF, the mean(SD) of the total costs per IPF patient per admission was 14882.3 (30975.8)CNY. The largest parts were the examination fee of 6034.5 (15651.2)CNY and the drug fee of 5048.9 (3855.1)CNY. By regression analysis we found that length of stay, emergency treatment, ventilator use and being a Beijing native were significantly (P<0.05) associated with total hospitalization costs, and the length of stay had the biggest impact. Complications or comorbidities contributated to the direct medical costs as follows: respiratory failure with 30898.3CNY (P=0.004), pulmonary arterial hypertension(PAH) with 26898.2CNY (P=0.098), emphysema with 25368.3CNY (P=0.033), and high blood pressure with 24659.4CNY (P=0.026). Using DLCO or DLCO% pred to reflect the severity of IPF, there was no significant correlation between DLCO or DLCO% pred and patients’ direct medical costs. While, the worse the diffusion function, the higher the drug fee.ConclusionThis study showed that IPF has a major impact on the direct medical costs. Thus, appropriate long-term interventions are recommended to lower the economic burden of IPF.Strengths and limitations of this studyIt was the first time in China to discuss the economic burden of diseases and its influencing factors in patients with IPF.The results of this study might be of reference for the establishment of IPF disease-related medical policies in future.The retrospective cross-sectional design does not allow for establishing any causal relationships.It was a a single-center study, resulting a slightly smaller sample size. A large sample of multicenter studies is needed to confirm this.

A Simple Method for the Evaluation of Internal Doses in Nuclear Medicine

1974 ◽  
Vol 13 (02) ◽  
pp. 193-206
Author(s):  
L. Conte ◽  
L. Mombelli ◽  
A. Vanoli
Keyword(s):  
Nuclear Medicine ◽  
Close Agreement ◽  
Whole Body ◽  
Simple Method ◽  
Rapid Estimation ◽  
Absorbed Doses ◽  
The Mean ◽  
The Individual ◽  
Estimation Of Risk

SummaryWe have put forward a method to be used in the field of nuclear medicine, for calculating internally absorbed doses in patients. The simplicity and flexibility of this method allow one to make a rapid estimation of risk both to the individual and to the population. In order to calculate the absorbed doses we based our procedure on the concept of the mean absorbed fraction, taking into account anatomical and functional variability which is highly important in the calculation of internal doses in children. With this aim in mind we prepared tables which take into consideration anatomical differences and which permit the calculation of the mean absorbed doses in the whole body, in the organs accumulating radioactivity, in the gonads and in the marrow; all this for those radionuclides most widely used in nuclear medicine. By comparing our results with dose obtained from the use of M.I.R.D.'s method it can be seen that when the errors inherent in these types of calculation are taken into account, the results of both methods are in close agreement.

SERUM THYROTROPHIN AND THE RESPONSE TO THYROTROPHIN RELEASING HORMONE IN SYMPTOMLESS AUTOIMMUNE THYROIDITIS AND IN BORDERLINE AND OVERT HYPOTHYROIDISM

1974 ◽  
Vol 75 (2) ◽  
pp. 274-285 ◽  
Author(s):  
A. Gordin ◽  
P. Saarinen ◽  
R. Pelkonen ◽  
B.-A. Lamberg
Keyword(s):  
Autoimmune Thyroiditis ◽  
Elevated Serum ◽  
Mean Value ◽  
Primary Hypothyroidism ◽  
Overt Hypothyroidism ◽  
Thyrotrophin Releasing Hormone ◽  
Releasing Hormone ◽  
The Mean ◽  
The Individual ◽  
Serum Tsh

ABSTRACT Serum thyrotrophin (TSH) was determined by the double-antibody radioimmunoassay in 58 patients with primary hypothyroidism and was found to be elevated in all but 2 patients, one of whom had overt and one clinically borderline hypothyroidism. Six (29%) out of 21 subjects with symptomless autoimmune thyroiditis (SAT) had an elevated serum TSH level. There was little correlation between the severity of the disease and the serum TSH values in individual cases. However, the mean serum TSH value in overt hypothyroidism (93.4 μU/ml) was significantly higher than the mean value both in clinically borderline hypothyroidism (34.4 μU/ml) and in SAT (8.8 μU/ml). The response to the thyrotrophin-releasing hormone (TRH) was increased in all 39 patients with overt or borderline hypothyroidism and in 9 (43 %) of the 21 subjects with SAT. The individual TRH response in these two groups showed a marked overlap, but the mean response was significantly higher in overt (149.5 μU/ml) or clinically borderline hypothyroidism (99.9 μU/ml) than in SAT (35.3 μU/ml). Thus a normal basal TSH level in connection with a normal response to TRH excludes primary hypothyroidism, but nevertheless not all patients with elevated TSH values or increased responses to TRH are clinically hypothyroid.

Manageable Self in the Early Hellenistic Era

2010 ◽  
Vol 39 (2) ◽  
pp. 34-36
Author(s):  
Vaia Touna
Keyword(s):  
Social Economic ◽  
Ancient Greece ◽  
The Self ◽  
Hellenistic Period ◽  
Political Conditions ◽  
The Individual

This paper argues that the rise of what is commonly termed "personal religion" during the Classic-Hellenistic period is not the result of an inner need or even quality of the self, as often argued by those who see in ancient Greece foreshadowing of Christianity, but rather was the result of social, economic, and political conditions that made it possible for Hellenistic Greeks to redefine the perception of the individual and its relationship to others.

Models, Practices and Methods of Reading: Evolution in Time and Space

2009 ◽  
pp. 59-64
Author(s):  
Yulia P. Melentyeva
Keyword(s):  
Large Scale ◽  
Social Groups ◽  
National Program ◽  
Time And Space ◽  
Lack Of Information ◽  
The Individual

In recent years as public in general and specialist have been showing big interest to the matters of reading. According to discussion and launch of the “Support and Development of Reading National Program”, many Russian libraries are organizing the large-scale events like marathons, lecture cycles, bibliographic trainings etc. which should draw attention of different social groups to reading. The individual forms of attraction to reading are used much rare. To author’s mind the main reason of such an issue has to be the lack of information about forms and methods of attraction to reading.

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