scholarly journals Minimizing the Risk of Catastrophic Health Expenditure in China: A Multi-Dimensional Analysis of Vulnerable Groups

2021 ◽  
Vol 9 ◽  
Author(s):  
Jiahui Wang ◽  
Xiao Tan ◽  
Xinye Qi ◽  
Xin Zhang ◽  
Huan Liu ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Low Socioeconomic Status ◽  
Health Expenditure ◽  
Household Head ◽  
Catastrophic Health Expenditure ◽  
Two Dimensions ◽  
Medical Expenditure ◽  
Vulnerable Groups ◽  
Low Socioeconomic

Background: In moving toward universal health coverage in China, it is crucial to identify which populations should be prioritized for which interventions rather than blindly increasing welfare packages or capital investments. We identify the characteristics of vulnerable groups from multiple perspectives through estimating catastrophic health expenditure (CHE) and recommend intervention priorities.Methods: Data were from National Health Service Survey conducted in 2003, 2008, and 2013. According to the recommendation of WHO, this study adopted 40% as the CHE threshold. A binary regression was used to identify the determinants of CHE occurrence; a probit model was used to obtain CHE standardized incidence under the characteristics of single and two dimensions in 2013.Results: The total incidence of CHE in 2013 was 13.9%, which shows a general trend of growth from 2003 to 2013. Families in western and central regions and rural areas were more at risk. Factors related to social demography show that households with a female or an unmarried head of household or with a low socioeconomic status were more likely to experience CHE. Households with older adults aged 60 and above had 1,524 times higher likelihood of experiencing CHE. Among the health insurance schemes, the participants covered by the New Rural Cooperative Medical Scheme had the highest risk compared with the participants of all basic health insurance schemes. Households with several members seeking outpatient, inpatient care or with non-communicable diseases were more likely to experience CHE. Households with members not seeing a doctor or hospitalized despite the need for it were more likely to experience CHE. Characteristics such as a household head with characteristics related to low socioeconomic status, having more than two hospitalized family members, ranked high. Meanwhile, the combination of having illiterate household heads and with being covered by other health insurance plans or by none ranked the first place. Cancer notably caused a relatively high medical expenditure among households with CHE.Conclusion: In China, considering the vulnerability of the population across different dimensions is conducive to the alleviation of high CHE. Furthermore, people with multiple vulnerabilities should be prioritized for intervention. Identifying and targeting them to offer help and support will be an effective approach.

scholarly journals Relationship of Socioeconomic Status to Arterial Stiffness: Comparison Between Medical Aid Beneficiaries and National Health Insurance Beneficiaries

2020 ◽  
Vol 33 (8) ◽  
pp. 718-725
Author(s):  
Hack-Lyoung Kim ◽  
Jin Yong Lee ◽  
Woo-Hyun Lim ◽  
Jae-Bin Seo ◽  
Sang-Hyun Kim ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Arterial Stiffness ◽  
National Health Insurance ◽  
National Health ◽  
Low Socioeconomic Status ◽  
Multivariable Analysis ◽  
Laboratory Findings ◽  
Low Socioeconomic ◽  
Medical Aid

Abstract Background There is no general agreement on underlying pathophysiology explaining the high burden of cardiovascular disease on people at low socioeconomic status (SES). This study was conducted to investigate the association between healthcare systems and arterial stiffness. Methods A total of 8,929 subjects (60 years old and 55% were male) who underwent brachial-ankle pulse wave velocity (baPWV) measurement were retrospectively analyzed. There were 8,237 National Health Insurance (NHI) beneficiaries (92.2%) and 692 medical aid (MA) beneficiaries (7.8%). The median value of baPWV was 1,540 cm/s. Results Subjects with higher baPWV values (≥1,540 cm/s) were older, and more frequently had cardiovascular risk factors and unfavorable laboratory findings than those with lower values baPWV (<1,540 cm/s). The baPWV values were significantly higher in MA beneficiaries than in NHI beneficiaries (1,966 ± 495 vs. 1,582 ± 346 cm/s, P < 0.001). The proportion of MA beneficiaries was significantly higher in subjects with higher baPWV than those with lower baPWV (13.1% vs. 2.3%, P < 0.001). In multivariable analysis, MA beneficiaries were significantly associated with higher baPWV values even after controlling for potential confounders (odds ratio, 5.41; 95% confidence intervals, 4.02–7.27; P < 0.001). Conclusions The baPWV values were significantly higher in MA beneficiaries than in NHI beneficiaries. The result of this study provides additional evidence on the association between low SES and arterial stiffening.

scholarly journals The effect of poverty on developmental screening scores among infants

2010 ◽  
Vol 128 (5) ◽  
pp. 276-283 ◽  
Author(s):  
Giselle Souza de Paiva ◽  
Ana Cláudia Vasconcelos Martins de Souza Lima ◽  
Marilia de Carvalho Lima ◽  
Sophie Helena Eickmann
Keyword(s):  
Socioeconomic Status ◽  
Child Development ◽  
Low Socioeconomic Status ◽  
Family Health ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
Socioeconomic Condition ◽  
Low Socioeconomic ◽  
Receptive Communication

CONTEXT AND OBJECTIVE: Child development is negatively influenced by multiple risk factors associated with poverty, thus indicating the importance of identifying the most vulnerable groups within populations that are apparently homogeneous regarding their state of socioeconomic deprivation. This study aimed to identify different levels of poverty in a population of low socioeconomic condition and to ascertain their influence on infants' neuropsychomotor development. DESIGN AND SETTING: Cross-sectional study conducted at four Family Health Units in the Health District IV in the city of Recife, Brazil. METHODS: The sample comprised 136 infants aged 9 to 12 months, which represented 86% of all the infants in this age group, registered at the units studied. Socioeconomic status was assessed through a specific index and child development through the Bayley III screening test. RESULTS: Around 20% of the families were in the lowest quartile of the socioeconomic level index and these presented the highest frequency of infants with suspected delay in receptive communication. Maternal and paternal unemployment negatively influenced receptive communication and cognition, respectively. Not possessing a cell phone (a reflection of low socioeconomic status) was associated with worse cognitive performance and gross motricity. Male infants showed a higher frequency of suspected delay in receptive communication. CONCLUSIONS: Infants of more precarious socioeconomic status more frequently present suspected developmental delay. Development monitoring and intervention programs should be encouraged for this subgroup, thereby providing these children with a better chance of becoming productive citizens in the future.

Tomorrow never knows: Paradoxical effects of a future prime on performance among low socioeconomic status college students

2014 ◽  
Author(s):  
Sarah Dayle Herrmann ◽  
Jessica Bodford ◽  
Robert Adelman ◽  
Oliver Graudejus ◽  
Morris Okun ◽  
...  
Keyword(s):  
College Students ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Low Socioeconomic ◽  
Paradoxical Effects

scholarly journals Home Language and Literacy Environments and Early Literacy Trajectories of Low‐Socioeconomic Status Chilean Children

2020 ◽  
Vol 91 (6) ◽  
pp. 2042-2062
Author(s):  
Susana Mendive ◽  
Mayra Mascareño Lara ◽  
Daniela Aldoney ◽  
J. Carola Pérez ◽  
José P. Pezoa
Keyword(s):  
Socioeconomic Status ◽  
Early Literacy ◽  
Low Socioeconomic Status ◽  
Home Language ◽  
Language And Literacy ◽  
Low Socioeconomic ◽  
Literacy Environments

scholarly journals Association of socioeconomic status with medical assistance in dying: a case–control analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043547
Author(s):  
Donald A Redelmeier ◽  
Kelvin Ng ◽  
Deva Thiruchelvam ◽  
Eldar Shafir
Keyword(s):  
Socioeconomic Status ◽  
Palliative Care ◽  
Low Socioeconomic Status ◽  
Case Control ◽  
Control Analysis ◽  
Medical Assistance ◽  
Low Socioeconomic ◽  
Medical Assistance In Dying ◽  
Income Status ◽  
Economic Constraints

ObjectivesEconomic constraints are a common explanation of why patients with low socioeconomic status tend to experience less access to medical care. We tested whether the decreased care extends to medical assistance in dying in a healthcare system with no direct economic constraints.DesignPopulation-based case–control study of adults who died.SettingOntario, Canada, between 1 June 2016 and 1 June 2019.PatientsPatients receiving palliative care under universal insurance with no user fees.ExposurePatient’s socioeconomic status identified using standardised quintiles.Main outcome measureWhether the patient received medical assistance in dying.ResultsA total of 50 096 palliative care patients died, of whom 920 received medical assistance in dying (cases) and 49 176 did not receive medical assistance in dying (controls). Medical assistance in dying was less frequent for patients with low socioeconomic status (166 of 11 008=1.5%) than for patients with high socioeconomic status (227 of 9277=2.4%). This equalled a 39% decreased odds of receiving medical assistance in dying associated with low socioeconomic status (OR=0.61, 95% CI 0.50 to 0.75, p<0.001). The relative decrease was evident across diverse patient groups and after adjusting for age, sex, home location, malignancy diagnosis, healthcare utilisation and overall frailty. The findings also replicated in a subgroup analysis that matched patients on responsible physician, a sensitivity analysis based on a different socioeconomic measure of low-income status and a confirmation study using a randomised survey design.ConclusionsPatients with low socioeconomic status are less likely to receive medical assistance in dying under universal health insurance. An awareness of this imbalance may help in understanding patient decisions in less extreme clinical settings.

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