scholarly journals Out-of-Pocket Spending for Cancer Medication, Financial Burden, and Cost Communication with Oncologists in the Last Six Months of Life in Israel

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1120
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Damien Urban
Keyword(s):  
Private Health Insurance ◽  
Financial Burden ◽  
Female Gender ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Complex Interactions ◽  
The Cost ◽  
Treatment Alternatives ◽  
Financial Burden Of Cancer ◽  
Heavy Financial Burden

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients. About 43% of relatives said that they and/or the patients had paid out of pocket for medications during the last six months of the patient’s life. Most (73%) oncologists suggested an OOP medication without asking about financial ability, 43% hardly explained the advantages of an OOP medication, and 52% hardly explained any treatment alternatives. Older age and female gender were related to less communication about an OOP medication, and better education, greater affluence, and having private health insurance were related to more communication. About 56% of relatives said that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. Physicians’ interest in financial ability and giving explanation lightened the burden. Given the difficulty of explaining the complex interactions of cost and clinical outcomes, oncologists need to be better educated in skills that would enable them to communicate costs more openly and should consider the cost of a treatment when prescribing it.

scholarly journals The cost of mental and physical health disability in childhood and adolescence to families in the UK: findings from a repeated cross-sectional survey using propensity score matching

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018729 ◽  
Author(s):  
Francesca Solmi ◽  
Mariya Melnychuk ◽  
Stephen Morris
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Childhood And Adolescence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Family ◽  
Additional Costs ◽  
The Uk ◽  
The Cost ◽  
Mental And Physical Health

ObjectiveIn the UK, families of disabled children are entitled to receive disability benefits to help meet costs associated with caring for their child. Evidence of actual costs incurred is scant, especially for mental health disability. In this study, we aimed to quantify the cost of mental and physical health disability in childhood and adolescence to families in the UK using the concept of compensating variation (CV).DesignRepeated cross-sectional survey.SettingThe UK general populationParticipants85 212 children drawn from 8 waves of the Family Resources Survey.OutcomesUsing propensity score matching we matched families with a disabled child to similar families without a disabled child and calculated the extra income the former require to achieve the same living standards as the latter, that is, their CV. We calculated the additional costs specifically associated with several definitions of mental health and physical health disability.ResultsFamilies of a child with any mental health disability, regardless of the presence of physical health comorbidity, needed an additional £49.31 (95% CI: 21.95 to 76.67) and, for more severe disabilities, an additional £57.56 (95% CI: 17.69 to 97.44) per week to achieve the same living standards of families without a disabled child. This difference was greater for more deprived families, who needed between £59.28 (95% CI: 41.38 to 77.18) and £81.26 (95% CI: 53.35 to 109.38) more per week depending on the extent of mental health disability. Families of children with physical health disabilities, with or without mental health disabilities, required an additional £35.86 (95% CI: 13.77 to 57.96) per week, with economically deprived families requiring an extra £42.18 (95% CI: 26.38 to 57.97) per week.ConclusionsMental and physical health disabilities among children and adolescents were associated with high additional costs for the family, especially for those from deprived economic backgrounds. Means testing could help achieve a more equitable redistribution of disability benefit.

scholarly journals FREQUENCY OF FUNCTIONAL DISABILITY AND COGNITIVE IMPAIRMENTS IN SUB-ACUTE STROKE PATIENTS

2021 ◽  
Vol 10 (2) ◽  
pp. 69-74
Author(s):  
Aisha Sarfaraz ◽  
Dr Abdul Azeem ◽  
Mehwish Butt ◽  
Muhammad Umar
Keyword(s):  
Acute Stroke ◽  
Functional Disability ◽  
Cognitive Impairments ◽  
Age Groups ◽  
Female Gender ◽  
Primary Objective ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND & OBJECTIVE Stroke is a very common neurological condition affects various aspects of health. The primary objective of this study was to find out the frequency of functional disability and cognitive impairments in Sub-acute Stroke patients. MATERIAL AND METHODS A cross-sectional survey was conducted on 112 Sub-acute Stroke patients in Karachi, Pakistan. Using Barthel Index (BI) and Mini-Mental State Examination (MMSE) test was used to find out the frequency of functional disability and cognitive impairments of Sub-acute Stroke patients. RESULTS The correlation of BI scores with MMSE scores for the Male gender was 0.576 whilst the correlation of BI scores with MMSE scores for the Female gender was 0.440. The severity of functional disability concerning age groups assessed P-value was 0.026 using Chi-Square Test. The severity of functional disability (BI severity) concerning gender, P-value was found 0.097 using the same test. CONCLUSION Functional Disability is directly linked with age. However, there was no linkage established between Cognitive Impairment and age as well as gender. On close inspection, there was a trend between Functional disability and gender but not statistically significant.

scholarly journals Cost awareness of radiological studies among doctors at Universitas Academic Hospital in Bloemfontein, South Africa

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Khanyisa N. Mrwetyana ◽  
Jacques Janse van Rensburg ◽  
Gina Joubert
Keyword(s):  
South Africa ◽  
Cost Estimation ◽  
Academic Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Education Training ◽  
The Cost ◽  
Cost Awareness ◽  
Radiological Studies

Background: South Africa has high healthcare expenses. Improving cost-consciousness could decrease government expenditure on healthcare.Objectives: To determine cost awareness of radiological studies among doctors at a tertiary hospital. The objective was met by assessing the accuracy of cost estimation according to the level of training and speciality, whether participants had received prior education/training related to cost awareness and if they had a desire to learn more about the cost of radiological imaging.Method: A cross-sectional survey was conducted in six clinical departments at Universitas Academic Hospital using an anonymous questionnaire that determined doctors’ cost awareness of five radiological studies. Each radiological study was answered using six different cost ranges, with one correct option. Costs were based on the Department of Health’s 2019 Uniform Patients Fee Schedule (UPFS).Results: In total, 131 (67.2%) of 195 questionnaires distributed to registrars and consultants were returned. Overall, low accuracy of cost estimation was observed, with 45.2% of the participants choosing only incorrect options. No participant estimated all five costs correctly. Only the Internal Medicine clinicians demonstrated a significant difference between registrars and consultants for the number of correct answers (median 0 and 1, respectively) (p = 0.04). No significant differences were found between specialities stratified by registrars/consultants. Most participants (88.6%) would like to learn about imaging costs. Only 2.3% of the participants had received prior education/training related to cost awareness of radiological studies.Conclusion: Doctors were consistently inaccurate in estimating the cost of radiological studies. Educating doctors about the cost of radiological imaging could have a positive effect on healthcare expenditure.

scholarly journals Perceived Knowledge of Scheme Members and Their Satisfaction with Their Medical Schemes: A Cross-Sectional Study in South Africa.

2021 ◽  
Author(s):  
Francis M’bouaffou ◽  
Eric Buch ◽  
Evelyn Thsehla ◽  
Steve Olorunju
Keyword(s):  
South Africa ◽  
Service Providers ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Perceived Satisfaction ◽  
Private And Public ◽  
The Cost

Abstract Background: South Africa has a dual healthcare system comprised of private and public sectors covering 16% and 84% of the population, respectively. Medical schemes are the primary source of health insurance in the private sector. The aim of this study was to assess the perceived knowledge and satisfaction of open medical schemes members. Methods: A cross-sectional survey was conducted using a stratified systematic sample of members from 22 open medical schemes. Nine hundred and sixty members were requested to complete an online semi-structured questionnaire to determine their perceived knowledge and satisfaction with their schemes. We tested to see if variables such as age, gender, years of membership, education, income or having a chronic disease were associated with better-perceived knowledge or satisfaction. We calculated a composite perceived knowledge and satisfaction score, for which a score above 60th percentile for perceived knowledge and 60th for perceived satisfaction were considered good perceived knowledge and good perceived satisfaction with their schemes.Results: Respondents, generally perceived themselves to have good knowledge and were satisfied with their schemes except for accessibility to doctors under the designated service providers arrangement. Overall, members were satisfied, especially with the quality of service from their designated service providers (DSPs) and their schemes. However, only 9% were satisfied with accessibility to doctors under their DSP arrangement, 25% were satisfied with the cost of scheme membership and only 46% were satisfied with the prescribed minimum benefit package. The test for association showed that years of medical schemes membership, perceived knowledge of the prescribed minimum benefits, better income and laying a complaint were associated with better-perceived knowledge. Conclusion: Medical schemes remain a key element of private healthcare in South Africa. The analysis shows that medical schemes, should put more effort into the accessibility of general practitioner under their designated service providers. Furthermore, the PMBS should be reviewed to provide a comprehensive benefits basket without co-payment for members as recommended by the Medical Schemes Act Amendment Bill of 2018.

Depression and Anxiety Plus Levels of Stress among Secondary School Students during the COVID-19 Lockdown: an Online CrossSectional Survey

2021 ◽  
Author(s):  
Gunn Pungpapong ◽  
Rasmon Kalayasiri
Keyword(s):  
Substance Use ◽  
Secondary School ◽  
Secondary School Students ◽  
Female Gender ◽  
Depression And Anxiety ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Increased Risk ◽  
Patient Health

Objective: To assess prevalence and factors associated with depression, anxiety and stress among adolescents experiencing lockdown during the 2019 coronavirus disease 2019 (COVID-19) in both Asian and Western countries. Material and Methods: From May-June 2020, secondary school students were enrolled in an online cross-sectional survey, through social media; including, but not limited to, Instagram, Snapchat, WhatsApp and LINE. We assessed the presence and severity of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Scale-7) and stress (Perceived Stress Scale-10) within the last month, and assessed significant associations with demographics, degree of social distancing, and other associated issues using univariate and multivariate logistic regression analyses.Results: From 392 respondents (56.4% male, 43.1% female), from Thailand (59.2%), the United Kingdom (26.5%) and other countries (14.3%), we identified depressive symptoms in 58.7%, anxiety in 40.3% and high levels of stress in 9.7%. By multivariate analysis, we found significant associations between being female and depression and anxiety, being in late secondary school years and depression, and changes in patterns of substance use and anxiety and stress. Participants not located in Thailand had increased risk of depression.Conclusion: Our study demonstrated depression, anxiety and stress in six, four and one out of ten adolescents, respectively, who were experiencing lockdowns due to the COVID-19 pandemic. We found female gender, older school years, and changes in substance use patterns to be significantly associated with these mental health conditions.

Knowledge and Expectations of Hearing Aid Applications: A Cross-sectional Survey of Smartphone Users and Hearing Professionals (Preprint)

2021 ◽  
Author(s):  
Jae Sang Han ◽  
Yong-Ho Park ◽  
Jae-Jun Song ◽  
Il Joon Moon ◽  
Woojoo Lee ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Personal Information ◽  
Hearing Aid ◽  
Assistive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cost Category ◽  
Grade Point ◽  
The Cost

BACKGROUND Despite the increasing prevalence of hearing loss, the cost and psychological barriers to use of hearing aids may prevent individuals with hearing loss from using these aids. Hearing loss patients can benefit from smartphone-based hearing aid applications (SHAAs), which are smartphone applications that use a mobile device as sound amplifier. OBJECTIVE The aims of this study were to determine how ear, nose and throat (ENT) outpatients perceived SHAAs, analyze factors that affected this, and estimate costs of annual subscription to an application through a self-administered questionnaire survey of smartphone users and hearing specialists. METHODS The study employed cross-sectional, multi-center survey of both ENT outpatients and hearing specialists. The questionnaire was designed to collect personal information about the respondents as well as responses to 18 questions concerning SHAAs in 5 domains: knowledge, needs, cost, expectations, and information. Questions about the expected cost of SHAAs were included in the questionnaire distributed to hearing experts. RESULTS Among 219 smartphone users and 42 hearing specialists, only eight respondents (3.7%) recognized SHAAs, while 47 of 261 respondents (21.5%) reported considering using an assistive device to improve their hearing capacities. Average perception score was 2.81 (95% CI 2.65-2.97), lower than the grade point average of 3. Among factors that shaped perceptions of SHAAs, the needs category received the lowest scores (2.02, 95% CI 1.83-2.20) whereas the cost category received the highest scores (3.29, 95% CI 3.14-3.44). Age was correlated with the information domain (P = .000) and an increased level of hearing impairment resulted in significantly higher points in the needs category (P = .000). Patients expected the cost of an annual application subscription to an SHAA to be about 86 USD, and predicted cost was associated with economic status (P = .200) and was noticeably higher than the prices expected by hearing specialists (P < .001). CONCLUSIONS Outpatients expected SHAAs to cost more than hearing specialists. However, SHAA perception was relatively low. In this regard, enhanced awareness of SHAAs is required to popularize SHAAs. CLINICALTRIAL None

scholarly journals Online Learning in the Face of COVID-19 Pandemic: Assessment of Students’ Satisfaction at Chitwan Medical College of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 40-47
Author(s):  
K. Sharma ◽  
G. Deo ◽  
S. Timalsina ◽  
A. Joshi ◽  
N. Shrestha ◽  
...  
Keyword(s):  
Online Learning ◽  
Student Satisfaction ◽  
Virus Disease ◽  
Female Gender ◽  
Weak Links ◽  
Online Classes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College ◽  
Students Satisfaction

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners’ satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners’ dimensions, technological characteristics, instructors’ characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students’ overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners’ dimension score [aOR: 1.27, p<0.001] were the significant predictors of students’ satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students’ satisfaction and better outcomes.

scholarly journals A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies

2020 ◽  
Vol 35 (6) ◽  
pp. 979-986 ◽  
Author(s):  
Arjan van der Tol ◽  
Vianda S Stel ◽  
Kitty J Jager ◽  
Norbert Lameire ◽  
Rachael L Morton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Home Dialysis ◽  
Kidney Replacement Therapy ◽  
The Cost ◽  
The Impact

Abstract Background We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. Methods This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data. Results The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P &lt; 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P &lt; 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P &lt; 0.001). Conclusions In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.

scholarly journals The affordability of prescription medicines in Australia: are copayments and safety net thresholds too high?

2013 ◽  
Vol 37 (1) ◽  
pp. 32 ◽  
Author(s):  
Andrew Searles ◽  
Evan Doran ◽  
Thomas A Faunce ◽  
David Henry
Keyword(s):  
Financial Burden ◽  
Monitoring And Evaluation ◽  
Access To Medicines ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Prescription Medicines ◽  
Main Determinants ◽  
The Cost

Objective. To create and report survey-based indicators of the affordability of prescription medicines for patients in Australia. Method. A cross-sectional study of 1502 randomly selected participants in the Hunter Region of NSW, were interviewed by telephone. Main outcome measure. The self-reported financial burden of obtaining prescription medicines. Results. Data collection was completed with a response rate of 59.0%. Participants who had received and filled at least one prescription medicine in the previous 3 months, and eligible for analysis (n=952), were asked to self-report the level of financial burden from obtaining these medicines. Extreme and heavy financial burdens were reported by 2.1% and 6.8% of participants, respectively. A moderate level of burden was experienced by a further 19.5%. Low burden was recorded for participants who said that their prescription medicines presented either a slight burden (29.0%) or were no burden at all (42.6%). Conclusion. A substantial minority of participants who had obtained prescription medicines in the 3 months prior to survey experienced a level of financial burden from the cost of these medicines that was reported as being moderate to extreme. What is known about the topic? The Australian National Medicines Policy aims to, amongst other things, facilitate access to medicines at a cost that is affordable to individuals and the community. Copayments combined with the safety net and brand price premium are the main determinants of the amount that patients pay for PBS listed prescription medicines. Previous surveys have reported on selected aspects of medicine affordability in Australia and have shown some groups in the population experience difficulty with the cost of their medicines. What does this paper add? This paper develops and reports on a set of indicators that can be used to periodically measure the level of self-reported financial burden experienced by Australians when obtaining prescription medicines. The analysis assesses affordability issues for both general patients and patients who are able to access prescription medicines using a concession card. What are the implications? Our research suggests that, as they stand, the copayment and safety net thresholds are not protecting nearly one-third of Australian patients from financial burden. Ongoing monitoring and evaluation is required to ensure the copayment and safety net thresholds do not jeopardise the National Medicines Policy’s principle of equitable and affordable access to medicines.

scholarly journals Delays to diagnosis among people with severe mental illness in rural Vietnam, a population-based cross-sectional survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trang Nguyen ◽  
Thach Tran ◽  
Sally Green ◽  
Arthur Hsueh ◽  
Tuan Tran ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Financial Burden ◽  
National Policy ◽  
Mental Health Program ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background People with severe mental illness (SMI) living in low and middle-income countries can experience extended delays to diagnosis, which hinder access to medical treatment. The aims of this study were to describe the interval to diagnosis among these people in rural Vietnam and its associated factors. Methods A population-based cross-sectional study was conducted among people with SMI in two provinces in Vietnam. The delay to diagnosis was defined as the time between the first abnormal behaviour being observed by family members and the formal diagnosis of psychosis. A multilevel linear regression was used to examine the factors associated with the delay to diagnosis. Results Among 404 people with SMI from 370 households, the median delay to diagnosis was 11.5 months (IQR 0–168.0). Overall, 53.7% had a delay to diagnosis of less than one year (95% CI: 48.81–58.54). The financial burden of these people on their families was nearly USD 470/year. After adjusting for other factors at individual and household levels, living in a Northern province; older age, and having psychotic diagnosis before the implementation of the National Community Mental Health program (2003) were associated with a delay of more than twelve months to diagnosis. Conclusions These data indicate that the implementation of a national policy for community-based care has been effective in reducing the delay to diagnosis in rural Vietnam. Therefore, there is a need for strengthening the program and mental health policies, focusing on public communication to improve mental health literacy and reduce stigma against SMI.

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