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Li C, Yan Z, Zhang J. Medical cost of environmental pollution: evidence from the Chinese Social Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:120155-120173. [PMID: 37936034 DOI: 10.1007/s11356-023-30459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023]
Abstract
Environmental pollution impairs residents' health, while the pursuit of health is highly correlated to medical costs. Understanding how environmental pollution affects medical costs is closely linked to the welfare of society. Based on theoretical analysis, this paper uses data from 5112 households of the Chinese Social Survey (CSS) in 2019, constructs a composite indicator to quantify environmental pollution using respondents' evaluations, and empirically investigates the causal effect of environmental pollution on household medical cost and the mechanism. The conclusions are shown as follows. First, environmental pollution can increase household medical costs, and this estimation result still holds after dealing with the endogeneity problem and other robustness tests. Second, there is heterogeneity in the impact of environmental pollution on household medical costs, households in the upper socioeconomic class, with heavy pension burdens or with strong health insurance coverage are more sensitive to environmental pollution and incur relatively higher household medical costs. Third, environmental pollution reduces residents' satisfaction with their spiritual life, which adversely affects their physical and mental health and can increase household medical costs. Residents' satisfaction with their spiritual life is an important mechanism for environmental pollution to affect household health care expenditures. Therefore, governments should enhance the enforcement of environmental protection and governance, strengthen the awareness of green issues and health education, and increase the supply of facilities for leisure and sports, thus reducing medical costs due to environmental pollution and easing the medical burden of residents.
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Affiliation(s)
- Chengyou Li
- School of Finance, Shandong University of Finance and Economics, Jinan, 250014, China
| | - Zhaojun Yan
- School of Finance, Shandong University of Finance and Economics, Jinan, 250014, China
| | - Jitian Zhang
- Clinical Nutrition Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
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Kifle F, Kifleyohanes T, Moore J, Teshome A, Biccard BM. Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review. World J Surg 2023; 47:1387-1396. [PMID: 36656359 PMCID: PMC10156757 DOI: 10.1007/s00268-023-06909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 01/20/2023]
Abstract
Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.
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Affiliation(s)
- Fitsum Kifle
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa. .,College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia. .,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.
| | - Tewodros Kifleyohanes
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | - Jolene Moore
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | | | - Bruce M Biccard
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.,Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa
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Abbas W, Eltayeb S. Psychosocial indicators of individual behavior during COVID 19: Delphi approach. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:344. [PMID: 36212913 PMCID: PMC9524736 DOI: 10.1057/s41599-022-01363-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic revealed the weakness of the health care system to incorporate indicators of human behavior in the rapid response to the virus. This study aims to establish consensus on the psychosocial indicators of COVID-19 preventive behaviors during the initial phase of the outbreak in Arab countries. This qualitative study used a combined scoping review of the literature to develop the 24 psychosocial indicators and the Delphi approach with a panel of 27 experts from nine Arab countries to achieve a consensus on preventive behavior indicators. The most robust agreement with an average rating of at least 4 was found for five social indicators including Belief System with an average rating (5). Income Status average rating (4.9). Family Commitment average rating (4). Faith average rating (4). Kinship System average rating (3.9). Four psychological indicators were identified namely Self-Efficacy with an average rating of (5). Perception of Hazard with an average rating of (4.5). Motivation with an average rating of (4.5). Stigma with an average rating of (4.2). The nine indicators provide a strong base for redesigning pandemic control interventions. The Delphi study demonstrates the feasibility of a participatory approach during the outbreak of COVID-19. Moreover, future interventions need to accommodate individual psychological and social determinants to increase adherence and decrease resistance to public health guidelines.
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Affiliation(s)
- Wijdan Abbas
- Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | - Shahla Eltayeb
- Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
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MORROW J, LAHER AE. Financial burden associated with attendance at a public hospital emergency department in Johannesburg. Afr J Emerg Med 2022; 12:102-105. [PMID: 35251920 PMCID: PMC8886001 DOI: 10.1016/j.afjem.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/01/2022] [Accepted: 02/08/2022] [Indexed: 11/19/2022] Open
Abstract
Poverty and inequality are two of the most significant issues affecting people living in Africa Catastrophic health care expenditure (CHCE), which is out-of-pocket expenditure on medical care that leads to a severe financial burden for the individual or household, affects 44 million individuals from 150 million households globally Various expenses including transport costs, general practitioner fees acquired prior to the EC visit, loans and loss of usual daily income contribute to the financial burden associated with a visit to the EC
Introduction: More than half of South Africans live below the poverty line. Indirect medical costs can contribute significantly to the financial burden of patients seeking medical care. The aim of this study was to determine the expenses incurred by patients and/or their escorts during a visit to the emergency centre (EC). Methods: Patients and/or their escorts presenting to an EC in Johannesburg were asked to complete the study questionnaire relating to expenses incurred during a visit to the EC. Results: Of the total 396 participants that completed the questionnaire, 108 (27.2%) did not have any source of income, 146 (36.9%) were the sole breadwinner in their household and 36 (9.1%) belonged to zero-income households. Among those earning ≤R2000 per month, the mean expenses relating to the EC visit was R240 (SD R372), equating to an average of 33.2% of mean monthly income. Transport costs were the most common expense (n=302, 76.3%), while general practitioner (GP) fees incurred prior to the EC visit accounted for the bulk of the expenses (median R450, IQR 350-820). Participants that earned >R2000 per month were significantly more likely to incur GP fees (p =0.012), while those earning ≤R2000 per month were significantly more likely to take a loan to cover EC related expenses (p =0.014). Conclusion: A visit to the EC can have a substantial financial impact on patients and their accompanying escorts in South Africa. Strategies should be aimed at identifying and assisting those that are in need of financial assistance to cover indirect healthcare costs.
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Bhatia D, Mishra S, Kirubarajan A, Yanful B, Allin S, Di Ruggiero E. Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews. BMJ Open 2022; 12:e052041. [PMID: 35264342 PMCID: PMC8915291 DOI: 10.1136/bmjopen-2021-052041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Financial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 universal health coverage (UHC) target. We sought to characterise what is known about FRP in the UHC context and to identify evidence gaps to prioritise in future research. DESIGN Scoping overview of reviews using the Arksey & O'Malley and Levac & Colquhoun framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. DATA SOURCES MEDLINE, PsycINFO, CINAHL-Plus and PAIS Index were systematically searched for studies published between 1 January 1995 and 20 July 2021. ELIGIBILITY CRITERIA Records were screened by two independent reviewers in duplicate using the following criteria: (1) literature review; (2) focus on UHC achievement through FRP; (3) English or French language; (4) published after 1995 and (5) peer-reviewed. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data using a standard form and descriptive content analysis was performed to synthesise findings. RESULTS 50 studies were included. Most studies were systematic reviews focusing on low-income and middle-income countries. Study periods spanned 1990 and 2020. While FRP was recognised as a dimension of UHC, it was rarely defined as a concept. Out-of-pocket, catastrophic and impoverishing health expenditures were most commonly used to measure FRP. Pooling arrangements, expansion of insurance coverage and financial incentives were the main interventions for achieving FRP. Evidence gaps pertained to the effectiveness, cost-effectiveness and equity implications of efforts aimed at increasing FRP. Methodological gaps related to trade-offs between single-country and multicountry analyses; lack of process evaluations; inadequate mixed-methods evidence, disaggregated by relevant characteristics; lack of comparable and standardised measurement and short follow-up periods. CONCLUSIONS This scoping overview of reviews characterised what is known about FRP as a UHC dimension and found evidence gaps related to the effectiveness, cost-effectiveness and equity implications of FRP interventions. Theory-informed mixed-methods research using high-quality, longitudinal and disaggregated data is needed to address these objectives.
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Affiliation(s)
- Dominika Bhatia
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujata Mishra
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Abirami Kirubarajan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Bernice Yanful
- Public Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Erica Di Ruggiero
- Public Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Biccard BM, Msosa V, Samateh AL. Prevention of surgical site infection in low-resource settings. Lancet 2021; 398:1664-1665. [PMID: 34710361 DOI: 10.1016/s0140-6736(21)01695-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Bruce M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa.
| | | | - Ahmadou L Samateh
- School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
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Silva-Rued ML, Ramírez-Romero A, Guerra-Maestre LR, Forero-Hollmann ÁM, Lozada-Martínez ID. The need to develop specialized surgical centers: the evidence that surgical diseases cannot wait. Int J Surg 2021; 92:106036. [PMID: 34339880 PMCID: PMC8321957 DOI: 10.1016/j.ijsu.2021.106036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023]
Affiliation(s)
| | | | | | | | - Ivan David Lozada-Martínez
- Medical and Surgical Research Center, School of Medicine, University of Cartagena, Cra. 50 #24120, Cartagena, Colombia.
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A commentary on "Economic impact of surgery on households and individuals in low income countries: A systematic review" [Int. J. Surg. 90 (2021) 105956]. Int J Surg 2021; 91:105991. [PMID: 34118438 DOI: 10.1016/j.ijsu.2021.105991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 01/28/2023]
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