Usage and Analysis of Big Data in E-Health Domain

Big data analytics is a growth area with the potential to provide useful insight in healthcare. Big Data can unify all patient related data to get a 360-degree view of the patient to analyze and predict outcomes. It can improve clinical practices, new drug development and health care financing process. It offers a lot of benefits such as early disease detection, fraud detection and better healthcare quality and efficiency. This chapter introduces the Big Data concept and characteristics, health care data and some major issues of Big Data. These issues include Big Data benefits, its applications and opportunities in medical areas and health care. Methods and technology progress about Big Data are presented in this study. Big Data challenges in medical applications and health care are also discussed. While many dimensions of big data still present issues in its use and adoption, such as managing the volume, variety, velocity, veracity, and value, the accuracy, integrity, and semantic interpretation are of greater concern in clinical application.

Promising measures to reduce the mortality in Russia: an analytical review

The purpose of the study was to identify promising measures to reduce mortality in Russia. Methods used included analysis of systematic reviews from PubMed, Web of Science, Scopus, and Google Scholar. Results. Many reasonable measures for reducing mortality in Russia include promoting healthy behaviour (tobacco control, alcohol control, support for healthy diet, physical activity) and preventing death due to external causes. It is necessary to increase the effectiveness of disease management, including arterial hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular accidents, hepatitis C, HIV. This could require intensifying digital transformation of health care, implementing modern teamwork approaches to the patient’s treatment and follow-up with greater involvement of nurses and other personnel. In terms of screening, it is essential to expand coverage and introduce modern, effective screening methods for colorectal cancer, cervical cancer, and neonatal screening. It is necessary to expand vaccination against Covid-19, vaccination of the elderly from Pneumococcus, and adolescents from HPV. Prevention of mortality from external causes should include sets of measures targeted at the prevention of suicides, traffic accidents, fires, drownings, etc., in addition to alcohol control measures. Finally, increasing health care financing, including medication provision, can bring additional years of life. Conclusions. Russia has significant potential to implement new measures to reduce the mortality rate.

Examining the Economic Perspective of Treatable Mortality: The Role of Health Care Financing and the Importance for Economic Prosperity

Health is an essential element of economic life and is therefore considered a source of comparative economic development of countries. The aim of the study was to examine the associations between health care financing, specific treatable mortality of males and females of working age, and economic prosperity, taking into account to the classification of health systems applied in the countries of the Organization for Economic Co-operation and Development (OECD). An insurance-based health system and a tax-based health system were identified in these countries, and data were collected for the period 1994–2016. Descriptive analysis, panel regression analysis and cluster analysis were used to achieve the aim. The analytical process included economic indicators [health expenditure, gross domestic product (GDP)] and health indicators (treatable mortality from circulatory system diseases and endocrine, nutritional and metabolic diseases). The results revealed significant negative associations of health care financing with treatable mortality from circulatory system diseases and endocrine, nutritional, and metabolic diseases in both health systems and both gender categories. There were also negative associations between treatable mortality in both diagnosis groups and economic prosperity. These results have shown that health care financing is linked to economic prosperity also through health variability in the working age population. In terms of assessing economic and health outcomes, less positive and more positive countries were identified using cluster analysis. Countries such as Latvia with a tax-based health system and Hungary, Lithuania, Estonia with an insurance-based health system were characterized by great potential for improvements. Although reducing treatable mortality is a great motivation for public health leaders to increase health care financing, the importance for economic prosperity may be a more compelling argument. Effective interventions should be considered in the light of their regional, social and economic contexts.

Equity of health care financing in South Korea: 1990–2016

Background The National Health Insurance in Korea has been in operation for more than 30 years since having achieved universal health coverage in 1989 and has gone through several policy reforms. Despite its achievements, the Korean health insurance has some shortfalls, one of which concerns the fairness of paying for health care. Method Using the population representative Household Income and Expenditure Survey data in Korea, this study examined the yearly changes in the vertical equity of paying for health care between 1990 and 2016 by the source of financing using the Kakwani index, considering health insurance and other related policy reforms in Korea during this period. Results The study results suggest that direct tax was the most progressive mode of health care financing in all years, whereas indirect tax was proportional. The out-of-pocket payments were weakly regressive in all years. The Kakwani index for health insurance contributions was regressive but now is proportional to the ability to pay, whereas the Kakwani index for private health insurance premiums turned from progressive to weakly regressive. The Kakwani index for overall health care financing showed a weak regressivity during the study period. Discussion The overall health care financing in Korea has transformed from a slight regressivity to proportional over time between 1990 and 2016. It is expected that these changes were closely related to the improved equity of health insurance contributions from 1998 to 2008, which was the result of a merger of the health insurance societies and an amendment in the health insurance contribution structure. These results suggest that standardizing insurance managing organizations and financing rules potentially has positive implications for the equity of healthcare financing in a country where the major method of health care financing is social health insurance.

Care in Context: Dementia Support in Mexico and the United States

Due to rapid demographic transitions, the number of people with dementia is rising in the Americas, and is expected to double in the coming decades, increasing from14.8 million in 2030 to over 27 million by 2050. The burden of dementia is especially pronounced for the Mexican-origin population in Mexico and the U.S. For Mexico, financial support for older low-income citizens and medical care are universal rights, but limited fiscal resources and the needs of a large low-income population create inevitable competition for limited resources among the old and the young. Although the United States has a more developed economy and well-developed Social Security and health care financing systems for older adults, Mexican-origin individuals in the U.S. do not necessarily benefit fully from these programs. The institutional and financial problems are compounded in both countries by longer life spans, smaller families, as well as changing gender roles and cultural norms. Such changes affect the Mexican-origin population in particular because of a higher prevalence rates of cognitive impairment than other racial and ethnic groups, and the lower access to resources to provide care. In this GSA Symposium, the authors of four papers deal with the following topics as they relate to dementia care in Mexico and the United States: (1) living alone in late life; (2) living arrangements and dementia care; (3) the role of non-governmental organizations in care; (4) next steps to address dementia care needs in the U.S. and Mexico.

Redistributive effects of health care out-of-pocket payments in Cameroon

Background The bulk of health care financing in Cameroon is derived from out-of-pocket payments. Given that poverty is pervasive, with a third of the population living below the poverty line, health care financing from out-of-pocket payments is likely to have redistributive and equity effects. In addition, out-of-pocket payments on health care can limit the ability of households to afford non-healthcare goods and services. Method The study estimates the Kakwani index for analyzing tax progressivity and applies the model developed by Aronson, Johnson, and Lambert (1994) to measure the redistributive effects of health care financing using data from the 2014 Cameroon Household Survey. The estimated indexes measure the extent of the progressivity of health care payments and the reranking that results from the payments. Results The results indicate that out-of-pocket payments for health care in Cameroon in 2014 represented a significant share of household prepayment income. The results also show some evidence of inequity as few people change ranks after payment despite the slight progressivity of health care out-of-pocket payments. Conclusion The existence of some disparities among income groups implies that the burdens of ill-health and out-of-pocket payments are unequal. The detected disparities within income groups can be reduced by targeting low-income groups through increases in government expenditures on health care and pro-poor prioritization of the expenditures.

Analysis of the Effect of Private Healthcare Financing on Poverty in Nigeria: Evidence from Edo State

Poverty is one of the problems that challenge economies in Africa. Though it is a complex phenomenon which requires efforts by different experts to reduce or eliminate, conventional wisdom posits that “health is wealth”. Health status is a component of human capital development which plays a fundamental role in the poverty and well-being of individuals and national economies. Paradoxically the cost of accessing quality healthcare is an important contributor to income poverty among low income households. Thus adequate healthcare financing mechanisms (public and private) are required to attain quality health outcomes. This study therefore investigates the adequacy or otherwise of the current means of private health care financing in Edo state of Nigeria and it employed the survey method and multinomial logistic regression technique. Results revealed that the dominant means of private health care financing in Edo state is “out of pocket” payments which has negative effect on the income of households. It therefore recommends the introduction of a more effective collective healthcare financing mechanism to mitigate the financial burden associated with out-of-pocket spending. Also funding should be provided for research and development of locally manufactured drugs with high local content to enhance the availability and affordability of effective drugs.

Challenges and experiences in linking community level reported out-of-pocket health expenditures to health provider recorded health expenditures: Experience from the iHOPE project in Northern Ghana

Out of pocket health payment (OOPs) has been identified by the System of Health Accounts (SHA) as the largest source of health care financing in most low and middle-income countries. This means that most low and middle-income countries will rely on user fees and co-payments to generate revenue, rationalize the use of services, contain health systems costs or improve health system efficiency and service quality. However, the accurate measurement of OOPs has been challenged by several limitations which are attributed to both sampling and non-sampling errors when OOPs are estimated from household surveys, the primary source of information in LICs and LMICs. The incorrect measurement of OOP health payments can undermine the credibility of current health spending estimates, an otherwise important indicator for tracking UHC, hence there is the need to address these limitations and improve the measurement of OOPs. In an attempt to improve the measurement of OOPs in surveys, the INDEPTH-Network Household out-of-pocket expenditure project (iHOPE) developed new modules on household health utilization and expenditure by repurposing the existing Ghana Living Standards Survey instrument and validating these new tools with a ‘gold standard’ (provider data) with the aim of proposing alternative approaches capable of producing reliable data for estimating OOPs in the context of National Health Accounts and for the purpose of monitoring financial protection in health. This paper reports on the challenges and opportunities in using and linking household reported out-of-pocket health expenditures to their corresponding provider records for the purpose of validating household reported out-of-pocket health expenditure in the iHOPE project.