The household economic burden of non-communicable diseases in 18 countries
| Autor: | Timothy Powell-Jackson, Katarzyna Zatońska, Iolanthé M. Kruger, Romaina Iqbal, Benjamin Palafox, Yang Wang, Lap Ah Tse, Martin McKee, I Rosnah, Annika Rosengren, Roya Kelishadi, Salim Yusuf, Adrianna Murphy, Viswanathan Mohan, Sumathy Rangarajan, Scott A. Lear, Patricio Lopez-Jaramillo, Alvaro Avezum, Khalid Yusoff, Prem Mony, Wei Li, Antonio L. Dans, Andres Orlandini, Lungiswa Tsolekile, Rajeev Gupta, Ruohua Yan, Kevser Burcu Tumerdem Calik, Karen Yeates, Marjan Walli-Attaei, Vellappillil Raman Kutty, Jephat Chifamba, Manmeet Kaur, Rasha Khatib, Gilles R. Dagenais, Andreas Wielgosz, Koon K. Teo, Khalid F. AlHabib, Pamela Seron, Tarzia Choudhury, Kara Hanson |
|---|---|
| Přispěvatelé: | Everest, Murphy, Adrianna, Palafox, Benjamin, Walli-Attaei, Marjan, Powell-Jackson, Timothy, Rangarajan, Sumathy, Alhabib, Khalid F., Avezum, Alvaro Jr, Calik, Kevser Burcu Tumerdem, Chifamba, Jephat, Choudhury, Tarzia, Dagenais, Gilles, Dans, Antonio L., Gupta, Rajeev, Iqbal, Romaina, Kaur, Manmeet, Kelishadi, Roya, Khatib, Rasha, Kruger, Iolanthe Marike, Kutty, Vellappillil Raman, Lear, Scott A., Li, Wei, Lopez-Jaramillo, Patricio, Mohan, Viswanathan, Mony, Prem K., Orlandini, Andres, Rosengren, Annika, Rosnah, Ismail, Seron, Pamela, Teo, Koon, Tse, Lap Ah, Tsolekile, Lungiswa, Wang, Yang, Wielgosz, Andreas, Yan, Ruohua, Yeates, Karen E., Yusoff, Khalid, Zatonska, Katarzyna, Hanson, Kara, Yusuf, Salim, Mckee, Martin |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
AFFORDABILITY
Male Disease SECONDARY PREVENTION 030204 cardiovascular system & hematology 0302 clinical medicine Cost of Illness cardiovascular disease Epidemiology Health care Medicine health economics SOCIOECONOMIC-STATUS Pakistan 030212 general & internal medicine Prospective Studies Cause of death Original Research lcsh:R5-920 Bangladesh biology diabetes Health Policy 1. No poverty Absolute risk reduction 3. Good health MIDDLE-INCOME CARDIOVASCULAR-DISEASE health insurance Female lcsh:Medicine (General) health systems medicine.medical_specialty China India LOW-INCOME COUNTRIES lcsh:Infectious and parasitic diseases 03 medical and health sciences Environmental health Humans lcsh:RC109-216 Risk factor Noncommunicable Diseases Sweden Health economics HYPERTENSION business.industry AVAILABILITY Public Health Environmental and Occupational Health biology.organism_classification Tanzania HEALTH-CARE PURE business |
| Zdroj: | BMJ Global Health Repositorio Universidad de Santander Universidad de Santander instacron:Universidad de Santander BMJ Global Health, Vol 5, Iss 2 (2020) |
| ISSN: | 2059-7908 |
| Popis: | Digital Background Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China. Results The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs. Conclusions Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs. Ciencias Médicas y de la Salud |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|