scholarly journals Inequality in Health: The Correlation between Poverty and Injury—A Comprehensive Analysis Based on Income Level in Taiwan: A Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 349
Author(s):  
Shi-Hao Huang ◽  
Shih-Chun Hsing ◽  
Chien-An Sun ◽  
Chi-Hsiang Chung ◽  
Chang-Huei Tsao ◽  
...  

Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher’s exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of “fall,” “suicide,” and “homicide” incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.

2020 ◽  
Author(s):  
Yi-Chang Lin ◽  
Chi-Hsiang Chung ◽  
Lu Pai ◽  
Chien-Sung Tsai ◽  
Wu-Chien Chien ◽  
...  

Abstract Background For better health promotion in Taiwan, it needs an action to reduce health inequality; therefore a comprehensive monitoring on social determinants and health is urgent. Is income the obstacle to influence the health after Taiwan instituted national health insurance in 1995? We compared the characteristics of accident injuries for patients classified with low-income and non-low-income who required inpatient care. Methods We collected accident injury inpatient cases from 1998 to 2015 from the Health and Welfare Data Science Center, Ministry of Health and Welfare and categorized the patients as low-income and non-low-income. Chi-square tests, Fisher exact tests, an independent samples t-test, and percentages were used to identify differences in demographics, cause for hospitalization, and other hospital care variables. Results Between 1998 and 2015, there were 74,337 low-income accident injury inpatients, which represented 1.6% of all injury event inpatients. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the non-low-income group. Further, the average length of hospital stay (9.9 days), average medical expenses (1,681 USD), and mortality rate (3.6%) for the low-income inpatients were higher than those of the non-low-income group (7.6 days, 1,573 USD, and 2.1%, respectively). Among the common injury causes, the percentage of injuries from “medical malpractice,” “fall,” “suicide,” and “homicide” were higher for the low-income group than that for the non-low-income group. Conclusions Despite National Health Insurance coverage, we found a higher hospitalization rate, longer average length of hospital stay, and a higher mortality rate in the low-income group. These findings support our hypothesis that there is a correlation between health and income level, resulting in health inequality. Achieving health care equality may require collaboration between the government and private and nonprofit organizations to increase awareness of this phenomenon.


2021 ◽  
Vol 21 (2) ◽  
pp. 306-314
Author(s):  
Azlina Mokhtar ◽  
Maimunah Abdul Muna'aim ◽  
Tengku Amatullah Madeehah T Mohd ◽  
Hafiz Jaafar

‘Klinik Pakar Mata Bergerak’ (KLiP Mobile), translated to specialised ophthalmology mobile clinic is a programme that provides ophthalmology care in the rural community of Negeri Sembilan. This study was conducted to determine the prevalence of cataracts and its associated factors among rural adults in Malaysia through an outreach programme of specialised ophthalmology services by KLiP Mobile. This is a cross-sectional study carried out from January 2016 until March 2018 and was conducted in rural areas of all seven districts in the state of Negeri Sembilanvisited by the KLiP Mobile. Universal sampling was applied to all adults attending the mobile clinic. The participants are those who were referred by the government community clinics and walk-in patients. The total number of participants in this study was 1480. The mean (SD) age for the study population was 56 (16.9), by which majority were Malay (n = 1220, 82.4%) and female (n = 809, 54.7%). Most of them received either primary (n = 604, 42.4%) or secondary education (n = 577, 40.5%). The majority of participants were categorized into the low-income group, with a monthly income of less than RM 3,000 (n = 1118, 92.4%). The prevalence of cataracts in the study population was 28.6%. In the multivariate analysis, factors significantly associated with cataracts were being male, having no formal education, race and suffering from hypertension. The prevalence of cataracts in rural areas is considerably high. This study highlights the need for baseline information for future study or as the main reference by the policymakers for policy development related to improving vision and eye care among the populations in Malaysia.  


Author(s):  
G Srimannarayana Et. al.

: The health insurance sector has grown at a double digit growth rate in India in the past decade. The Government schemes for the individuals' insurance coverage from the low-income group have resulted in higher penetration. Raise in the disposable income of the middle income and awareness of health insurance has led to self-subscription by private individuals. An increase in insurance penetration has also led to an increment in the claims for the insurer. However, the insurance coverage has been actively subscribed by the population in the age group of 19-64 years. The average claim amount processed is higher in infants and aged people. Days of hospitalization for the insured treatment help the insurers derive the claims' amounts and hence can budget the reserves accordingly. Days of hospitalization is found to have a strong positive relationship with age. Logistic regression of Half-yearly bins data has the predictability of Days of hospitalization of claimants at 69%.


2018 ◽  
Vol 1 (1) ◽  
pp. 33-42
Author(s):  
Yulia Farida Yahya ◽  
Fifa Argentina ◽  
Rusmawardiana Rusmawardiana

Scabies is a parasitic infestation of the skin, that is affecting on the low income and crowded community in many tropical countries, especially developing countries such as Indonesia. Scabies infestation increases the incidence of secondary pyoderma include impetigo, folliculitis, cellulitis, ecthyma, abscess. Secondary pyoderma is a skin infection disease mainly caused by     group A Streptococcus (GAS) and Staphylococcus aureus (SA). Pyoderma is a risk factor for the glomerulonephritis infection, rheumatic diseases, which significantly increases morbidity and mortality, causing the government burden. The aim of this study is  determining the etiology and correlation of pyoderma infection in scabies patient. To determine sosio-demographic included sex, age in pediatric patients in primary schools (SD) in the district of Kertapati Palembang. The study design was cross sectional, and study samples were new scabies patients in the elementary school (age 6-14-year-old) with or without pyoderma. Clinical findings included history, physical examination and diagnostic procedure, which was investigation of skin scraping specimen material (SSB = skin surface biopsy) in confirmation with dermoscopic polar examination (DS) to show Sarcoptes scabiei mites. Microbiological examination with Gram stain identified the etiology of pyoderma.  Results of this study shows that there was a significance relationship between scabies infestation and pyoderma in children in elementary school. Staphylococcus aureus dan GAS are the most common caused of pyoderma in pediatric patients with scabies. Conclusion is there is a significant correlation between scabies and pyoderma. There is  a need to provide scabies and pyoderma medication at primary care health center as well as counseling for prevention in Palembang area with crowded population periodically.  


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.


2021 ◽  
Vol 7 (1) ◽  
pp. 48-59
Author(s):  
Anom Dwi Prakoso

  Background: The Indonesian Government's target of Universal Coverage or 100% Health Insurance participation by 2019 failed to be achieved, even until the end of October 2020. The failure of universal coverage resulted in BPJS Health's finances getting worse after experiencing a deficit. Informal sector workers are the most dominant sector that has not participated in the Health Insurance scheme, totaling 30,487,891 workers. Low income, uncertainty each month, and the increase in contributions resulted in a decrease in Willingness to pay Health Insurance contributions. Research purposes: The purpose of this study is to analyze the effect of income, knowledge, and disease susceptibility to the willingness to pay (WTP) of health insurance contributions to informal sector workers. Method: This cross-sectional research was conducted in Kudus Regency, Central Java in January-February 2020. Sampling used purposive sampling with a total of 200 informal sector workers who had not yet participated in BPJS Kesehatan. The dependent variable is a willingness to pay. The independent variables are income, knowledge, and disease susceptibility. Data collection using a questionnaire and data analysis with logistic regression. Result: Willingness To Pay health insurance contributions for informal sector workers increased in income ≥Rp 2,218,451 (b = 2.02; 95% CI = 1.01-3.55; p = 0.044), high knowledge (b = 4.64; 95% CI = 2.36-8.31; p <0.001), high disease susceptibility (b = 3.01; 95% CI = 0.26-5.75; p = 0.031). Conclusion: Income, knowledge, and disease vulnerability have a significant effect on the willingness to pay for health insurance contributions for informal sector workers.   Keywords: Universal Health Coverage; Willingness To Pay; Health Insurance; informal sector workers.


2021 ◽  
Vol 05 (04) ◽  
pp. 110-116
Author(s):  
Huu Thang Nguyen ◽  
◽  
Thi Nguyet Minh Doan ◽  
Thanh Huong Tran ◽  
Hai Thanh Pham

Objectives: Medical facilities with an autonomous tendency always try to serve positive and pleasant experiences to improve the brand name, increase patient satisfaction and loyalty. A descriptive cross-sectional study was conducted on 245 inpatients at Lung Hospital in Son La province in 2020. To describe the current situation of the inpatient's experience at Lung Hospital in Son La province by 2020 and its related factors. Methods: This was a cross-sectional study conducted on 245 inpatients at Son La Lung Hospital Results: The study showed that the total score of inpatients’ experience ranged from 22 points to 57 points and the mean of it was 39.7 (6.13) points. Subject's experience scores were divided into 2 groups, the satisfied group accounted for 32.7% and the percentage of the unsatisfied group was 67.3%. As compared to men, a higher total score of women was (OR: 1.134; 95% CI: 0.284-0.997). The urban area group’s score was 1,190 times higher than that of those who live in rural and mountainous areas (95% CI: 1,010 - 1,400). The middle-income group had more positive experience than the low-income group (OR: 1.180; 95% CI: 1.010 - 1.370). Conclusions: Our research showed that gender, living area and economic condition affected the total score of inpatients’ experience at the Lung hospital. Keywords: Patient experiences, inpatient treatment, hospital, associated factors


2013 ◽  
Vol 49 (4) ◽  
pp. 679-687
Author(s):  
Marcelle Silva de Abreu ◽  
Silvandro Diego de Albuquerque Ferreira ◽  
Larissa Pelágia de Lima Ferreira ◽  
José Ferreira Toneo Júnior ◽  
Wamberto Vieira Maciel ◽  
...  

A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 - 2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.


2018 ◽  
Vol 31 (1) ◽  
pp. 151-166
Author(s):  
Laily Dwi Arsyianti Laily Dwi Arsyianti

This paper aims to develop a framework to improve financial prudence through financial education and financial inclusion for low-income households in Indonesia. Knowledge shapes attitude, which later influences behavior. A household, in terms of its social production function, needs to feel secure financially in order not to fall into insolvency or bankruptcy. Households that are equipped with better financial education and knowledge are more likely to undertake recommended financial behaviors. By targeting the low-income group through a financial inclusion agenda, the government, Islamic social finance practitioners, and academicians enable low-income households to act with financial prudence.


The role of public sector bank, in raising the economic equality on low income or middle income group, the term financial inclusion emphasis on redistribution of income within the same household, the deprive section of society avail the benefit with some standard provided by the government and how the approach have been taken by public sector bank to distribute the same and their behavioral ethics trail over the schemes. The study focused the dominant properties which fabricate imperative on financial inclusion among various categories of customers in public sector banks and also investigated the recognition of public in stand point of financial assistance and financial features offered by public sector bank through correlation statistical analysis with the sample of 200 with Chennai arena..


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