The burden of chronic diseases, disease-stratified exploration and gender-differentiated healthcare utilisation among patients in Bangladesh.

Autor: Mahumud RA; Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh.; NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.; School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia., Gow J; School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia.; School of Accounting, Economics and Finance, College of Law and Management Studies, University of KwaZulu-Natal, Durban, South Africa., Mosharaf MP; Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh.; School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia., Kundu S; Global Health Institute, North South University, Dhaka, Bangladesh.; Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh., Rahman MA; Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh., Dukhi N; Human Sciences Research Council, Cape Town, South Africa., Shahajalal M; Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh., Mistry SK; Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.; ARCED Foundation, Dhaka, Bangladesh.; Department of Public Health, Daffodil International University, Dhaka, Bangladesh.; Brain and Mond Centre, The University of Sydney, Camperdown, New South Wales, Australia., Alam K; School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 May 02; Vol. 18 (5), pp. e0284117. Date of Electronic Publication: 2023 May 02 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0284117
Abstrakt: Background: Chronic diseases are considered one of the major causes of illness, disability, and death worldwide. Chronic illness leads to a huge health and economic burden, especially in low- and middle-income countries. This study examined disease-stratified healthcare utilisation (HCU) among Bangladesh patients with chronic diseases from a gender perspective.
Methods: Data from the nationally representative Household Income and Expenditure Survey 2016-2017 consisting of 12,005 patients with diagnosed chronic diseases was used. Gender differentiated chronic disease stratified-analytical exploration was performed to identify the potential factors to higher or lower utilisation of healthcare services. Logistic regression with step-by-step adjustment for independent confounding factors was the method used.
Results: The five most prevalent chronic diseases among patients were gastric/ulcer (Male/Female, M/F: 16.77%/16.40%), arthritis/rheumatism (M/F: 13.70%/ 13.86%), respiratory diseases/asthma/bronchitis (M/F: 12.09% / 12.55%), chronic heart disease (M/F: 8.30% / 7.41%), and blood pressure (M/F: 8.20% / 8.87%). Eighty-six percent of patients with chronic diseases utilised health care services during the previous 30 days. Although most patients received outpatient healthcare services, a substantial difference in HCU among employed male (53%) and female (8%) patients were observed. Chronic heart disease patients were more likely to utilise health care than other disease types, which held true for both genders while the magnitude of HCU was significantly higher in males (OR = 2.22; 95% CI:1.51-3.26) than their female counterparts (OR = 1.44; 1.02-2.04). A similar association was observed among patients with diabetes and respiratory diseases.
Conclusion: A burden of chronic diseases was observed in Bangladesh. Patients with chronic heart disease utilised more healthcare services than patients experiencing other chronic diseases. The distribution of HCU varied by patient's gender as well as their employment status. Risk-pooling mechanisms and access to free or low-cost healthcare services among the most disadvantaged people in society might enhance reaching universal health coverage.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Mahumud et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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