scholarly journals Cost-Sharing Effects on Hospital Service Utilization Among Older People in Fukuoka Prefecture, Japan

2020 ◽  
Author(s):  
Yunfei Li ◽  
Akira Babazono ◽  
Aziz Jamal ◽  
Peng Jiang ◽  
Takako Fujita
Keyword(s):  
Service Utilization ◽  
Cost Sharing ◽  
Income Level ◽  
Hospital Service ◽  
Middle Income ◽  
Income Levels ◽  
Hospitalization Cost ◽  
The Cost ◽  
Psychiatric Beds ◽  
Total Hospitalization Cost

Background: The cost-sharing impact on hospital service utilization of different services is a critical issue that has not been well addressed worldwide. This study aimed to investigate the cost-sharing effects based on income status on hospital service utilization of different services among elderly people in Japan and provide a comprehensive examination and discussion for the reasonability of a cost-sharing system. Methods: The data were extracted from the Latter-Stage Elderly Healthcare Insurance database in the fiscal year 2016. A total of 610 182 insured people aged ≥75 years old, with 155 773 hospitalization patients, were identified. Hospitalization rate, length of stay (LOS), and total hospitalization cost were used to test the statistical significance among patients categorized by income levels. Generalized linear models for total hospitalization cost were constructed based on bed types to further assess different hospital service utilization. Results: For medical chronic care and psychiatric beds, which both required long-term care treatment, much higher hospitalization rates were observed in the patients with low- and middle-income levels than patients with high-income level. The LOS and total hospitalization cost of the patients with low- and middle-income levels were significantly higher than the patients with high-income level treated in medical chronic care and psychiatric beds. For psychiatric beds, the total hospitalization cost for patients with low-income level was significantly higher than that for patients with highincome level. Conclusion: The cost-sharing policy in Japan, especially the cap for out-of-pocket needs further determination. The importance of community-based care services needs to be emphasized, and the collaboration between hospitals and community-based care facilities should be enhanced.

Lower Income Levels Correlate With Increased Prevalence of Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

2021 ◽  
Author(s):  
Qiong He ◽  
Mengyuan Zhang ◽  
Yongle Wang ◽  
Jin Zhang ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gestational Diabetes ◽  
Low Income ◽  
Web Of Science ◽  
Meta Analysis ◽  
Income Level ◽  
Cochrane Library ◽  
Lower Income ◽  
Middle Income ◽  
Income Levels

Abstract BackgroundIncome level is an important factor that influences the occurrence of gestational diabetes. Thus, this systematic review and network meta-analysis aimed at evaluating the correlation between income levels and the prevalence of gestational diabetes. MethodsRelevant published studies were searched in Pubmed, Web of Science, Cochrane library, and Ovid from the establishment time of database to January 3, 2020. Finally, 13 eligible clinical studies involving 1,817,801 women were selected from a total of 3776 studies and included in this study. The statistical softwares Revman5.3 and Stata14.0 were used to compare the prevalence of gestational diabetes in five different income levels; low, lower middle, medium, upper middle, and high. ResultsThe incidences of gestational diabetes in people with different economic income levels were: high income <middle income <upper middle income <lower middle income <low income. ConclusionThere is no linear correlation between income levels and incidences of gestational diabetes. However, the overall prevalence of gestational diabetes is inversely proportional to income level, that is, the higher the income level, the lower the prevalence of gestational diabetes.

scholarly journals Causal Relationship Between Air Transport and Economic Growth: Evidence from Panel Data for High, Upper-Middle, Lower-Middle and Low-Income Countries

2019 ◽  
Vol 22 (3) ◽  
pp. 24-43
Author(s):  
Kasım Kiracı ◽  
Mahmut Bakır
Keyword(s):  
Economic Growth ◽  
Causal Relationship ◽  
Low Income ◽  
Income Level ◽  
Air Transport ◽  
Low Income Countries ◽  
Middle Income ◽  
Panel Causality ◽  
Income Levels ◽  
Study Panel

This study aims to find out the causal relationship between air transport and economic growth based on income level. To this end, selected countries with high-income, uppermiddle-income, lower-middle-income, and low-income levels were included in the analyses for this study. Focusing on the 1990-2016 period, a total of 70 countries were classified according to their income levels and were analyzed empirically. In the study, panel causality analyzes by Kónya (2006) and Emirmahmutoğlu & Köse (2011) were used. Our findings show that GDP has a certain degree of effect on air transport. They also indicate that the unidirectional or bidirectional causal relationships running from GDP to air transport and air transport to GDP vary by the income level of countries.

PENGARUH PEMBERIAN TANDA TERIMA KASIH DAN TINGKAT PENDAPATAN APARATUR TERHADAP GRATIFIKASI

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Yulius Yulius
Keyword(s):  
Income Level ◽  
Income Levels ◽  
Research Instrument ◽  
The Impact

The Governments in carrying out its function, is constrained by gratification practices that conducted with the apparatus, this research aims to discover the influence of people's habits in their gratitude to the gratification; The impact of apparatus’ income level to the gratification;the impact of community habits that show their gratitude and the income levels of the apparatus collectively to the gratification. This research instrument used the questionnaires which distributed to the apparatus, with the conclusion: Community's habits that represent their gratitude for gratification; the income level of the apparatus impact the gratification; the community's habits that represent their gratitude and the apparatus’ income level as together affecting the gratification, even contributing 40.4% of the gratification.Keywords: habit; income; gratification

Renovating the View of Cost Sharing for the Underground Low Voltage Cable Projects in Hanoi

2019 ◽  
Vol 35 (5E) ◽  
Author(s):  
Pham Thi Thu Ha ◽  
Phan Dieu Huong
Keyword(s):  
Willingness To Pay ◽  
Cost Sharing ◽  
Low Voltage ◽  
Power Grid ◽  
Field Studies ◽  
Power Industry ◽  
Well Field ◽  
The Subject ◽  
Sharing Responsibility ◽  
The Cost

Underground power grid projects in Hanoi is so urgent that it requires immediate implementation. To synchronously and quickly implement the underground power grid projects, people in charge should not follow the outdated perspectives of just including the power industry, but also need to call for the support and cost sharing responsibility from consumers. This paper aims at approaching the subject both from the producers and consumers’ perspectives to together sharing the cost of putting the power grid underground not only in Hanoi but other metropolitans in Vietnam as well. Field studies (including 104 families) at Hoan Kiem District, Hanoi and CBA method were applied to investigate the willingness to pay (WTP) level of consumers to share the cost with the power industry for the underground power grid projects in Hanoi. The overview of the results shows that cost for the underground power grid in Hoan Kiem District ranging from 30,000 VND/household/month to 46,000VND/household/month. On the other hand, the willingness to pay of a typical household of four people within Hoan Kiem District ranges from 17,000VND/month to 24,000VND/month, with the most favorable method of annual payment within a detailed timeline.

scholarly journals Cost-Effectiveness Analysis of BCG Vaccination against Tuberculosis in Indonesia: A Model-Based Study

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 707
Author(s):  
Afifah Machlaurin ◽  
Franklin Christiaan Karel Dolk ◽  
Didik Setiawan ◽  
Tjipke Sytse van der Werf ◽  
Maarten J. Postma
Keyword(s):  
Cost Effectiveness ◽  
Univariate Analysis ◽  
Cost Effective ◽  
Epidemiological Data ◽  
Control Programme ◽  
Detection Rates ◽  
Middle Income ◽  
Bcg Vaccination ◽  
Life Years ◽  
The Cost

Bacillus Calmette–Guerin (BCG), the only available vaccine for tuberculosis (TB), has been applied for decades. The Indonesian government recently introduced a national TB disease control programme that includes several action plans, notably enhanced vaccination coverage, which can be strengthened through underpinning its favourable cost-effectiveness. We designed a Markov model to assess the cost-effectiveness of Indonesia’s current BCG vaccination programme. Incremental cost-effectiveness ratios (ICERs) were evaluated from the perspectives of both society and healthcare. The robustness of the analysis was confirmed through univariate and probabilistic sensitivity analysis (PSA). Using epidemiological data compiled for Indonesia, BCG vaccination at a price US$14 was estimated to be a cost-effective strategy in controlling TB disease. From societal and healthcare perspectives, ICERs were US$104 and US$112 per quality-adjusted life years (QALYs), respectively. The results were robust for variations of most variables in the univariate analysis. Notably, the vaccine’s effectiveness regarding disease protection, vaccination costs, and case detection rates were key drivers for cost-effectiveness. The PSA results indicated that vaccination was cost-effective even at US$175 threshold in 95% of cases, approximating the monthly GDP per capita. Our findings suggest that this strategy was highly cost-effective and merits prioritization and extension within the national TB programme. Our results may be relevant for other high endemic low- and middle-income countries.

scholarly journals Street Food Stand Availability, Density, and Distribution Across Income Levels in Mexico City

2021 ◽  
Vol 18 (8) ◽  
pp. 3953
Author(s):  
Jose B. Rosales Chavez ◽  
Meg Bruening ◽  
Punam Ohri-Vachaspati ◽  
Rebecca E. Lee ◽  
Megan Jehn
Keyword(s):  
Mexico City ◽  
Food Environment ◽  
Local School ◽  
Middle Income ◽  
Street Food ◽  
Income Levels ◽  
Rigorous Approach ◽  
Ground Truthing ◽  
Document Relationships ◽  
Street Segments

Street food stands (SFS) are an understudied element of the food environment. Previous SFS studies have not used a rigorous approach to document the availability, density, and distribution of SFS across neighborhood income levels and points of access in Mexico City. A random sample (n = 761) of street segments representing 20 low-, middle-, and high-income neighborhoods were assessed using geographic information system (GIS) and ground-truthing methods. All three income levels contained SFS. However, SFS availability and density were higher in middle-income neighborhoods. The distribution of SFS showed that SFS were most often found near homes, transportation centers, and worksites. SFS availability near schools may have been limited by local school policies. Additional studies are needed to further document relationships between SFS availability, density, and distribution, and current structures and processes.

scholarly journals Cost per DALY averted in low, middle- and high-income countries: evidence from the global burden of disease study to estimate the cost-effectiveness thresholds

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rajabali Daroudi ◽  
Ali Akbari Sari ◽  
Azin Nahvijou ◽  
Ahmad Faramarzi
Keyword(s):  
Cost Effectiveness ◽  
Inverse Correlation ◽  
Gdp Per Capita ◽  
Middle Income ◽  
Capita Health Expenditure ◽  
Per Capita ◽  
Healthcare Interventions ◽  
Disease Study ◽  
The Cost ◽  
Very High

Abstract Background Determining the cost-effectiveness thresholds for healthcare interventions has been a severe challenge for policymakers, especially in low- and middle-income countries. This study aimed to estimate the cost per disability-adjusted life-year (DALY) averted for countries with different levels of Human Development Index (HDI) and Gross Domestic Product (GDP). Methods The data about DALYs, per capita health expenditure (HE), HDI, and GDP per capita were extracted for 176 countries during the years 2000 to 2016. Then we examined the trends on these variables. Panel regression analysis was performed to explore the correlation between DALY and HE per capita. The results of the regression models were used to calculate the cost per DALY averted for each country. Results Age-standardized rate (ASR) DALY (DALY per 100,000 population) had a nonlinear inverse correlation with HE per capita and a linear inverse correlation with HDI. One percent increase in HE per capita was associated with an average of 0.28, 0.24, 0.18, and 0.27% decrease on the ASR DALY in low HDI, medium HDI, high HDI, and very high HDI countries, respectively. The estimated cost per DALY averted was $998, $6522, $23,782, and $69,499 in low HDI, medium HDI, high HDI, and very high HDI countries. On average, the cost per DALY averted was 0.34 times the GDP per capita in low HDI countries. While in medium HDI, high HDI, and very high HDI countries, it was 0.67, 1.22, and 1.46 times the GDP per capita, respectively. Conclusions This study suggests that the cost-effectiveness thresholds might be less than a GDP per capita in low and medium HDI countries and between one and two GDP per capita in high and very high HDI countries.

Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

2021 ◽  
pp. 1-24
Author(s):  
Ricardo Alves ◽  
Carla Lopes ◽  
Sara Rodrigues ◽  
Julian Perelman
Keyword(s):  
Mediterranean Diet ◽  
Food Group ◽  
Food Prices ◽  
Mediterranean Country ◽  
Linear Regression Models ◽  
Middle Income ◽  
Diet Cost ◽  
The Mediterranean ◽  
The Cost ◽  
Activity Survey

Abstract Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population’s diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

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