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Guo M, Li Z, Song T, Ma R, Lv B, Zhang X, Zhao T, Chen Y, Tang Z. Analysis of hospitalization expenditures and influencing factors for inpatients with chronic bronchitis based on SHA2011 in a central Province of China. Sci Rep 2024; 14:23495. [PMID: 39379562 DOI: 10.1038/s41598-024-74521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/26/2024] [Indexed: 10/10/2024] Open
Abstract
This study compared the hospitalization expenses of patients with chronic bronchitis in a central province (Province A) in China to estimate the direct medical cost of the family. Our data included hospitalization records of 30,341 patients with chronic bronchitis from five urban general hospitals in Province A. Using descriptive statistics and regression analysis, we explored the relevant factors affecting hospitalization expenses. Our study results have indicated that from 2016 to 2020, the medical expenditure of patients with chronic bronchitis increased annually, with an average annual growth rate of 22.65%. Among all kinds of expenses, the hospitalization expenses, drug cost, bed cost, test cost and other cost of UEMI (Urban Employee Medical Insurance) are higher than that of other types of medical insurance. The check-up fees of CMI (Commercial Insurance) are lower than that of other types of insurance. Between 2016 and 2019, the average medical expenses per patient with chronic bronchitis increased by 44%, which is the highest average medical expenses among patients aged 60-70. And the highest average medical expenditure emerged when the number of service days is between 5 and 10 days. The increase in expenditure could be attributed to the rapid development of medical technology and the increasing medical demand of the people. Overall, the results of our study implied a significant increase in medical expenses for patients with chronic bronchitis from 2015 to 2020, indicating that chronic bronchitis could bring heavy economic pressures to patients, their families and society.
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Affiliation(s)
- Mengzi Guo
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Zihang Li
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Tianyu Song
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Rongfei Ma
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Bangliang Lv
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Xiange Zhang
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Tianming Zhao
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China
| | - Yuting Chen
- Research Department, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, Anhui, P. R. China
| | - Zhiru Tang
- School of Health Management, Anhui Medical University, Hefei, 230032, Anhui, P. R. China.
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Wongkrajang P, Jittikoon J, Udomsinprasert W, Talungchit P, Chaikledkaew U. Economic cost of patients with trisomy 13, 18, and 21 in a tertiary hospital in Thailand. PLoS One 2023; 18:e0291918. [PMID: 37972090 PMCID: PMC10653468 DOI: 10.1371/journal.pone.0291918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/10/2023] [Indexed: 11/19/2023] Open
Abstract
The purpose of this study was to determine direct and indirect costs of patients with trisomy (T) 13, 18, and 21 in Thailand. Direct medical costs were obtained from Siriraj Informatics and Data Innovation Center (SiData+), Faculty of Medicine, Siriraj Hospital, and indirect costs were estimated using a human capital approach. About 241 patients with T21 had outpatient care visits and 124 patients received inpatient care. For T13 and T18, five and seven patients were analyzed for outpatient and inpatient cares, respectively. For patients with T13, T18, and T21 receiving outpatient care, total annual mean direct medical costs ranged from 183.2 USD to 655.2 USD. For inpatient care, average yearly direct medical costs varied between 2,507 USD to 14,790 USD. The mean and median increased with age. In outpatient care, costs associated with drugs and medical devices were a major factor for both T13 and T21 patients, whereas laboratory costs were substantial for T18 patients. For inpatient care, costs of drug and medical devices were the greatest for T13 patients, while service fee and operation costs were the highest for T18 and T21 patients, respectively. For outpatient care, adult patients with congenital heart disease (CHD) had significantly higher mean annual direct medical costs than those without CHD. However, all adult and pediatric patients with CHD receiving inpatient care had significantly higher costs. Patients with T13, T18, and T21 had relative lifetime costs of 22,715 USD, 11,924 USD, and 1,022,830 USD, respectively.
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Affiliation(s)
- Preechaya Wongkrajang
- Social, Economic and Administrative Pharmacy (SEAP) Graduate Program, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraphun Jittikoon
- Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | | | - Pattarawalai Talungchit
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
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Wongkrajang P, Jittikoon J, Udomsinprasert W, Talungchit P, Sangroongruangsri S, Turongkaravee S, Chaikledkaew U. Economic evaluation of prenatal screening for fetal aneuploidies in Thailand. PLoS One 2023; 18:e0291622. [PMID: 37713438 PMCID: PMC10503713 DOI: 10.1371/journal.pone.0291622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/02/2023] [Indexed: 09/17/2023] Open
Abstract
Historically, there has been a lack of cost-effectiveness data regarding the inclusion of universal non-invasive prenatal testing (NIPT) for trisomy 21, 18, and 13 in the benefit package of the Universal Health Coverage (UHC) in Thailand. Therefore, this study aimed to perform the cost-benefit analysis of prenatal screening tests and calculate the budget impact that would result from the implementation of a universal NIPT program. A decision-tree model was employed to evaluate cost and benefit of different prenatal chromosomal abnormalities screenings: 1) first-trimester screening (FTS), 2) NIPT, and 3) definitive diagnostic (amniocentesis). The comparison was made between these screenings and no screening in three groups of pregnant women: all ages, < 35 years, and ≥ 35 years. The analysis was conducted from societal and governmental perspectives. The costs comprised direct medical, direct non-medical, and indirect costs, while the benefit was cost-avoidance associated with caring for children with trisomy and the loss of productivity for caregivers. Parameter uncertainties were evaluated through one-way and probabilistic sensitivity analyses. From a governmental perspective, all three methods were found to be cost-beneficial. Among them, FTS was identified as the most cost-beneficial, especially for pregnant women aged ≥ 35 years. From a societal perspective, the definitive diagnostic test was not cost-effective, but the other two screening tests were. The most sensitive parameters for FTS and NIPT strategies were the productivity loss of caregivers and the incidence of trisomy 21. Our study suggested that NIPT was the most cost-effective strategy in Thailand, if the cost was reduced to 47 USD. This evidence-based information can serve as a crucial resource for policymakers when making informed decisions regarding the allocation of resources for prenatal care in Thailand and similar context.
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Affiliation(s)
- Preechaya Wongkrajang
- Social, Economic and Administrative Pharmacy (SEAP) Graduate Program, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraphun Jittikoon
- Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | | | - Pattarawalai Talungchit
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Saowalak Turongkaravee
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
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Aparicio P, Barba R, Moldenhauer F, Suárez C, Real de Asúa D. What brings adults with Down syndrome to the hospital? A retrospective review of a Spanish cohort between 1997 and 2014. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:143-152. [DOI: 10.1111/jar.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Raquel Barba
- Department of Internal Medicine Hospital Universitario Rey Juan Carlos Madrid Spain
| | - Fernando Moldenhauer
- Adult Down Syndrome Outpatient Unit, Department of Internal Medicine Hospital Universitario de la Princesa Madrid Spain
| | - Carmen Suárez
- Adult Down Syndrome Outpatient Unit, Department of Internal Medicine Hospital Universitario de la Princesa Madrid Spain
| | - Diego Real de Asúa
- Adult Down Syndrome Outpatient Unit, Department of Internal Medicine Hospital Universitario de la Princesa Madrid Spain
- Down Syndrome Medical Interest Group‐USA (DSMIG‐USA)
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Morris JK, Garne E, Loane M, Barisic I, Densem J, Latos-Bieleńska A, Neville A, Pierini A, Rankin J, Rissmann A, de Walle H, Tan J, Given JE, Claridge H. EUROlinkCAT protocol for a European population-based data linkage study investigating the survival, morbidity and education of children with congenital anomalies. BMJ Open 2021; 11:e047859. [PMID: 34183346 PMCID: PMC8240574 DOI: 10.1136/bmjopen-2020-047859] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Congenital anomalies (CAs) are a major cause of infant mortality, childhood morbidity and long-term disability. Over 130 000 children born in Europe every year will have a CA. This paper describes the EUROlinkCAT study, which is investigating the health and educational outcomes of children with CAs for the first 10 years of their lives. METHODS AND ANALYSIS EUROCAT is a European network of population-based registries for the epidemiological surveillance of CAs. EUROlinkCAT is using the EUROCAT infrastructure to support 22 EUROCAT registries in 14 countries to link their data on births with CAs to mortality, hospital discharge, prescription and educational databases. Once linked, each registry transforms their case data into a common data model (CDM) format and they are then supplied with common STATA syntax scripts to analyse their data. The resulting aggregate tables and analysis results are submitted to a central results repository (CRR) and meta-analyses are performed to summarise the results across all registries. The CRR currently contains data on 155 594 children with a CA followed up to age 10 from a population of 6 million births from 1995 to 2014. ETHICS The CA registries have the required ethics permissions for routine surveillance and transmission of anonymised data to the EUROCAT central database. Each registry is responsible for applying for and obtaining additional ethics and other permissions required for their participation in EUROlinkCAT. DISSEMINATION The CDM and associated documentation, including linkage and standardisation procedures, will be available post-EUROlinkCAT thus facilitating future local, national and European-level analyses to improve healthcare. Recommendations to improve the accuracy of routinely collected data will be made.Findings will provide evidence to inform parents, health professionals, public health authorities and national treatment guidelines to optimise diagnosis, prevention and treatment for these children with a view to reducing health inequalities in Europe.
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Affiliation(s)
- Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
| | - Ester Garne
- Paediatric Department, Hospital Lillebaelt, Kolding, Denmark
| | - Maria Loane
- Faculty of Life and Health Sciences, Ulster University, Coleraine, UK
| | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | | | - Anna Latos-Bieleńska
- Polish Registry of Congenital Malformations, Chair and Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Amanda Neville
- IMER Registry (Emila Romagna Registry of Birth Defects), University Hospital of Ferrara, Emilia-Romagna, Italy
| | - Anna Pierini
- Instituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Otto von Guericke University Medical Faculty, Magdeburg, Germany
| | - Hermien de Walle
- Department of Genetics, University Medical Centre Groningen, Groningen, The Netherlands
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | - Joanne Emma Given
- Faculty of Life and Health Sciences, Ulster University, Coleraine, UK
| | - Hugh Claridge
- Population Health Research Institute, St George's University of London, London, UK
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Lee A, Knafl K, Van Riper M. Family Variables and Quality of Life in Children with Down Syndrome: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020419. [PMID: 33430335 PMCID: PMC7825751 DOI: 10.3390/ijerph18020419] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022]
Abstract
The purpose of this scoping review was to identify the family and child quality of life variables that have been studied in relation to one another in children with Down syndrome, the frequency with which different relationships have been studied, and the extent to which family variables were the focus of the research aims. A literature search was conducted to find studies published between January 2007 and June 2018. The initial search yielded 2314 studies; of these, 43 were selected for a final review. Researchers most often addressed family resources and family problem-solving and coping concerning child personal development and physical well-being. Little attention to child emotional well-being was observed, with none considering family appraisal of child emotional well-being. The relationship between family variables and child QoL rarely was the primary focus of the study. Methodologically, most reviewed studies used cross-sectional designs, were conducted in North America and based on maternal report. From future research considering the issues found in this review, healthcare providers can obtain an in-depth understanding of relationships between children and family variables.
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Affiliation(s)
- Anna Lee
- School of Nursing, Korea University, Seoul 02841, Korea
- Correspondence: ; Tel.: +82-2-3290-4900
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA; (K.K.); (M.V.R.)
| | - Marcia Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA; (K.K.); (M.V.R.)
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The direct health care cost to Medicare of Down syndrome dementia as compared with Alzheimer's disease among 2015 Californian beneficiaries. Ann Phys Rehabil Med 2020; 64:101430. [PMID: 32853759 DOI: 10.1016/j.rehab.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Aging individuals with Down syndrome (DS) are at increased risk of dementia due to trisomy of chromosome 21 on which the amyloid precursor protein gene is located and with increased life expectancy. Yet, little is known about the costs associated with DS dementia and how this compares to Alzheimer's disease (AD). OBJECTIVE To better understand direct healthcare costs and care consumption in DS dementia, we compared the total cost of care to US Medicare and the drivers of these medical expenditures in individuals with DS with and without dementia, and in those with AD without DS. METHODS The effect of dementia in DS on costs and care utilization was estimated with 2015 California Medicare fee-for-service data (parts A and B). Among 3,001,977 Californian Medicare beneficiaries, 353 individuals had DS with dementia (age 45-89 years). We compared their number of chronic comorbidity conditions among 27 and their care and Medicare costs to those of age- and sex-matched individuals with DS without dementia and those with AD without DS. RESULTS Medicare annual cost per beneficiary was a mean of 43.5% and 82.2% higher with DS dementia (mean $35,011) than DS without dementia (mean $24,401) and AD without dementia (mean $19,212), related to greater utilization of inpatient services. DS dementia was associated with increased level of multimorbidity (mean of 3.4 conditions in addition to dementia vs. 2.7 and 2.2 conditions for DS without dementia and AD, respectively), with more emergency room visits (88% vs. 76.5% and 54.4%) and with more primary care physician visits (91.2% vs. 87.3% and 81.3%). CONCLUSION DS adults with dementia have higher health care costs than DS adults without dementia and adults with AD. Understanding costs and complex health care needs in DS dementia could facilitate management of adult and geriatric care resources for these high-need high-cost individuals.
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He J, Yin Z, Duan W, Wang Y, Wang X. Factors of hospitalization expenditure of the genitourinary system diseases in the aged based on "System of Health Account 2011" and neural network model. J Glob Health 2018; 8:020504. [PMID: 30356462 PMCID: PMC6184416 DOI: 10.7189/jogh.08.020504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Hospitalization expenditure of genitourinary system diseases among the aged is often overlooked. The aim of our research is to analyze the basic situation and influencing factors of hospitalization expenditure of the genitourinary system diseases and provide better data for the health system. Methods A total of 1 377 681 patients aged 65 years and over were collected with multistage stratified cluster random sampling in 252 medical institutions in Liaoning China, and “System of Health Account 2011” (SHA2011) was conducted to analyze the expenditure of the diseases. The corresponding samples were extracted, the neural network model was utilized to fit the regression model of the diseases among the aged, and sensitivity analysis was used to rank the influencing factors. Results Total hospitalization expenditure in Liaoning was 51.286 billion yuan, and curative care expenditure of diseases of the genitourinary system was 3.350 billion yuan, accounting for 6.53%. In the neural network model, the training set of R2 was 0.71. The test set of R2 was 0.74. In the sensitivity analysis, top-three influencing factors were the length of stay, type of institutions and type of insurances; the weight was 0.28, 0.19 and 0.14, respectively. Conclusions This research used SHA2011 to grab a large amount of data and analyzed them depending upon the corresponding dimensions. The neural network can analyze the influencing factors of hospitalization expenditure of genitourinary diseases in elderly patients accurately and directly, and can clearly describe the extent of its impact by combining sensitivity analysis.
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Affiliation(s)
- Junlin He
- School of Public Health, China Medical University, Wuxi No. 2 People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Zhuo Yin
- College of Metropolitan Transportation, Beijing University of Technology, Beijing, China
| | - Wenjuan Duan
- College of the Humanities and Social Sciences, China Medical University, Shenyang, China
| | | | - Xin Wang
- College of the Humanities and Social Sciences, China Medical University, School of Public Health, Xinjiang Medical University, Urumqi, China
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Mendiratta P, Wei JY, Dayama N, Li X. Outcomes for Hospitalized Older Adults with Down Syndrome in the United States. J Alzheimers Dis 2018; 66:377-386. [DOI: 10.3233/jad-171067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Priya Mendiratta
- Department of Geriatrics, College of Medicine-University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Jeanne Y. Wei
- Department of Geriatrics, College of Medicine-University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Neeraj Dayama
- Department of Health Policy and Management, Little Rock, AR, USA
| | - Xiaocong Li
- Department of Health Policy and Management, Little Rock, AR, USA
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Health and Health Service Use of Youth and Young Adults with Intellectual and Developmental Disabilities. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0082-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lin LP, Wu TY, Lin JD. Comparison of job burnout and life satisfaction between native and foreign female direct care workers in disability institutions. Work 2015; 52:803-9. [PMID: 26409362 DOI: 10.3233/wor-152117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is little information about the burnout and wellbeing of institutional caregivers working for people with intellectual and developmental disabilities; information is particularly limited in the understanding of experiences of direct care workers. OBJECTIVE The aims of the study were to provide a profile of self-perceived burnout and wellbeing of direct-care caregivers working in disability institutions, and to compare the difference between native- and foreign caregivers. METHODS A cross-sectional survey was conducted. We recruited 46 female living assistants of people with intellectual and developmental disabilities in two disability institutions in Taiwan. There were 23 subjects who were local residents and 23 subjects who were foreign providers of labor. A self-administered questionnaire which included scale of the Copenhagen Burnout Inventory (CBI), the Subjective Happiness Scale (SHS), and the Satisfaction with Life Scale (SWLS) were employed in the survey. RESULTS Findings revealed the local caregivers were slightly higher than foreign caregivers in personal burnout score (PBS) and work-related burnout score (WBS), although there were no significant differences. Those caregivers from foreign countries seem to be slightly happier and have higher life satisfaction than native caregivers. CONCLUSIONS In order to decrease the burnout and improve wellbeing of caregivers of people with intellectual and developmental disabilities, service providers should understand the experiences which caregivers encounter in their workplaces. Caregivers can benefit if they receive appropriate support to improve positive health while working for their service clients.
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Affiliation(s)
- Lan-Ping Lin
- Department of Senior Citizen Service Management, Ching Kuo Institute of Management and Health, Keelung, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Tzu-Ying Wu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Chung-Hua Foundation for Persons with Intellectual Disabilities, New Taipei City, Taiwan
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Vekeman F, Gauthier-Loiselle M, Faust E, Lefebvre P, Lahoz R, Duh MS, Sacco P. Patient and Caregiver Burden Associated With Fragile X Syndrome in the United States. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:444-459. [PMID: 26322391 DOI: 10.1352/1944-7558-120.5.444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study evaluated the incremental healthcare costs associated with Fragile X syndrome (FXS) for patients and their caregivers. Using administrative healthcare claims data (1999-2012), subjects with ≥ 1 FXS diagnosis (ICD-9-CM: 759.83) were matched 1:5 with non-FXS controls using high-dimensional propensity scores. Costs and resource utilization were examined. Among employees, payment for disability leave and absenteeism were also examined. We identified 590 FXS and 2,950 non-FXS individuals along with 647 and 2,611 caregivers, respectively. FXS patients and their caregivers experienced higher all-cause direct costs compared to control cohorts (total[SD]: $14,677[46,752] vs. $6,103[26,081]; $5,259[19,360] vs. $2,120[6,425], respectively, p < 0.05). Employed FXS patients and caregivers had higher indirect costs compared to their controls (total[SD]: $4,477[5,161] vs. $1,751[2,556]; $2,641[4,238] vs. $1,211[1,936], respectively, p < 0.05).
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Hsiao CY. Family demands, social support and family functioning in Taiwanese families rearing children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:549-59. [PMID: 23682672 DOI: 10.1111/jir.12052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2013] [Indexed: 05/10/2023]
Abstract
BACKGROUND Down syndrome (DS) affects not only children but also their families. Much remains to be learned about factors that influence how families of children with DS function, especially families in non-Western populations. The purpose of this cross-sectional, correlational study was to examine how family demographics, family demands and social support relate to family functioning as well as the potential mediating effect of social support on the relationship between family demands and family functioning in Taiwanese families of children with DS. METHOD One hundred and fifty-five parents (80 mothers and 75 fathers) from 83 families independently completed mailed questionnaires. Data were analysed using a principal component analysis and mixed linear modelling. RESULTS Families having older children with DS, greater parental education, higher family income, fewer family demands and greater social support contributed to healthier family functioning. Social support partially mediated the effects of family demands on family functioning. CONCLUSIONS Family demographics, family demands and social support appear to be important factors that may play a critical role in how Taiwanese families respond to the birth of a child with DS. Care of children with DS and their families is likely to be more effective if professionals working with these families are aware of factors that contribute to healthy family functioning.
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Affiliation(s)
- C-Y Hsiao
- College of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
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Lin JD, Lin LP, Kuo MT, Hsu SW, Lee TN, Lai CI, Wu JL. Assessment of the 9-item Patient Health Questionnaire (PHQ-9) as a screen tool for symptoms of depression in community caregivers for adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:178-184. [PMID: 24183645 DOI: 10.1016/j.ridd.2013.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 10/03/2013] [Indexed: 06/02/2023]
Abstract
The study aim was to determine the extent and determinants of reporting depressive symptoms in caregivers for persons with intellectual disabilities based on assessment of the 9-item Patient Health Questionnaire (PHQ-9). A cross-sectional study was conducted, recruiting 455 caregivers for adults with ID who were providing care in community residences, with complete PHQ-9 data being analyzed. The results indicated that the mean of each item scored on the PHQ-9 varied from 0.3 (Q9) to 1.1 (Q4). For two items (Q3 - "sleeping difficulties" and Q4 - "fatigue"), the respondents reported occurrence during several days in the previous two weeks. However, after scrutinizing the distribution of each item in the PHQ-9, 3.3-14.5% respondents reported that each item happened nearly every day, and 4.0-17.8% expressed that each happened more than half of the days in the previous two weeks. With respect to difficulties examined on the PHQ, 47% of cases expressed that it was somewhat difficult, 8.2% expressed that it was very difficult, and 4.5% felt that it was extremely difficult to work, care for things at home, or get along with others. Finally, a logistic regression model revealed that only one factor of self-perceived health status (fair/poor vs. excellent/very good, OR=7.519, 95% CI=3.03-18.68, p<0.001) exhibited a statistically significant correlation with depressive symptom occurrence (PHQ-9 score ≥ 10) among the caregivers. The study highlights the need to strengthen appropriate health initiatives for monitoring mental health status and to provide necessary services for community caregivers for adults with ID.
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Affiliation(s)
- Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Chung-Hua Foundation for Persons with Intellectual Disabilities, New Taipei City, Taiwan.
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Yen CF, Lin JD, Chiu TY. Comparison of population pyramid and demographic characteristics between people with an intellectual disability and the general population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:910-915. [PMID: 23291507 DOI: 10.1016/j.ridd.2012.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 11/21/2012] [Indexed: 06/01/2023]
Abstract
The purposes of this study were to measure disparities of age structure between people with an intellectual disability and general population, and to explore the difference of demographic characteristics between these two populations by using data from a population based register in Taiwan. Data were analyzed by SPSS 20.0 statistical software. Results found that the gender and mean age were significantly different between people with an intellectual disability and general population (mean age: 28.86 years vs. 35.26 years; p<0.001). The shape of the pyramid in general population tended to be fatty in the middle age, and intellectual disability population was more populous in the younger age. Furthermore, there were very few people with an intellectual disability can live more than 65 years old (3%) while there were nearly 10% of the general population were the elderly. The results also showed that two groups were different in marital status, educational levels, family status of veteran and aborigine (p<0.001). As the premature aging and short life span of people with an intellectual disability, this study suggested that the government authority should initiate necessary assistance for this group of people in the future.
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Affiliation(s)
- Chia-Feng Yen
- Department of Public Health, Tzu-Chi University, Hualien City, Taiwan
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Zhu JL, Hasle H, Correa A, Schendel D, Friedman JM, Olsen J, Rasmussen SA. Hospitalizations among people with Down syndrome: a nationwide population-based study in Denmark. Am J Med Genet A 2013; 161A:650-7. [PMID: 23404922 DOI: 10.1002/ajmg.a.35711] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 09/20/2012] [Indexed: 01/09/2023]
Abstract
Most persons with Down syndrome (DS) now survive to adulthood, but their health care needs beyond childhood are not well described. We followed a national cohort of 3,212 persons with DS and a reference cohort of persons without DS through the Danish National Hospital Register from January 1, 1977, to May 31, 2008. Poisson regression was used to calculate rate ratios for numbers of overnight hospital admissions and hospital days. During the study period, persons with DS had more than twice the rate of hospital admissions and nearly three times as many bed-days as the population as a whole. Malformations, diseases of the respiratory system, and diseases of the nervous system or sensory organs were the principal indications for hospital admissions. The higher rate ratios for hospital admissions were seen especially among persons less than 20 years of age. Hospitalizations for neoplasms or for diseases of the musculoskeletal system or connective tissue were much less frequent among adults with DS. As survival among persons with DS continues to improve, these findings are likely to be useful for health care planning, although the potential utility may be different for different health care systems.
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Affiliation(s)
- Jin Liang Zhu
- Section of Epidemiology, Department of Public Health, University of Aarhus, Denmark.
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