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Zazdravnykh E, Aistov A, Aleksandrova E. Total expenditure elasticity of spending on self-treatment and professional healthcare: a case of Russia. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:81-105. [PMID: 37022649 DOI: 10.1007/s10754-023-09353-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The studies on the demand for healthcare in low- and middle-income countries rarely take into consideration the fact that many people spend their income on self-treatment and professional treatment. The estimation of the income elasticity of demand for self-treatment and professional treatment can show a more precise picture of the affordability of professional care. This paper contributes to the discussion around estimates of income elasticity of health spending and discussion whether professional care and self-treatment are close to a luxury good and inferior good respectively in a middle-income country. We apply the switching regression model to explain the choice between self-treatment and professional healthcare via estimates of the income elasticity. Estimates are made with the use of the Russian Longitudinal Monitoring Survey - Higher School of Economics (RLMS-HSE), a nationally representative survey. While individual expenditure on professional treatment is higher than that on self-treatment, our estimates show that expenses on professional treatment can be income inelastic except when spending on medicines prescribed by a physician that are elastic. The results also indicate that cost of self-treatment is income elastic. In all cases, the considered income elasticities are statistically insignificant between professional and self-treatment.
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Affiliation(s)
- Evguenii Zazdravnykh
- Evguenii Zazdravnykh, HSE University, Saint Petersburg, Russia.
- Graduate School of Management, St. Petersburg University, Saint-Petersburg, Russia.
| | - Andrey Aistov
- Andrey Aistov, HSE University, Niznhy Novgorod, Russia
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Nguyen CT, Nguyen HT, Boyer L, Auquier P, Fond G, Do KN, Dang AK, Do HP, Latkin CA, Ho RCM, Ho CSH. Prevalence and impacts of self-medication in a disadvantaged setting: the importance of multi-dimensional health interventions. Front Public Health 2023; 11:1176730. [PMID: 37575118 PMCID: PMC10412933 DOI: 10.3389/fpubh.2023.1176730] [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: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Self-medication is recognized as an effective form of treatment and is increasingly encouraged to treat minor illnesses. However, misuse of self-medication leaves devastating impacts on human health and causes antimicrobial resistance. Using medication without a prescription among farmers could cause more severe effects on their health than non-farm workers since they suffer from several occupational hazards such as excessive exposure to pesticides. Methods A cross-sectional study was conducted in 197 residents living in Moc Chau from August to September. A structured questionnaire and face-to-face were used to collecting data. The multivariate logistic model was applied to indicate associated factors with the self-medication. Results The prevalence of self-medication among farmers was 67%. Pain relievers (66.7%) and antibiotics (32.5%) were the types of medicines that were the most commonly purchased and used without a medical prescription. Ethnics and health status also significantly affected the self-medication practice as well as the purchase and use of antibiotics. The distance to travel to a medical center and the dangerous or difficult travel, participants with arthritis or inpatient treatment had significantly associated with buying and using the medicine and antibiotics without the medical prescription of farmers. Conclusion Our research highlights a considerably high prevalence of self-medication among farmers residing in the mountainous area of Vietnam. Individual factors such as ethnics, health status, distance to health centers, and dangerous or difficult travel were found to be related to the SM practice as well as the purchase and use of antibiotics. From that, the current study suggests interventions. For instance, official guidelines are needed to raise awareness and minimize the disadvantages of self-medication; and digital health technologies should be applied to reduce the gap in healthcare service between mountainous and other areas of Vietnam.
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Affiliation(s)
- Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Laurent Boyer
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Pascal Auquier
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Guillaume Fond
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Ogunlana MO, Govender P, Oyewole OO, Odole AC, Falola JL, Adesina OF, Akindipe JA. Qualitative exploration into reasons for delay in seeking medical help with diabetic foot problems. Int J Qual Stud Health Well-being 2021; 16:1945206. [PMID: 34219610 PMCID: PMC8259813 DOI: 10.1080/17482631.2021.1945206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose Delay in reporting foot symptoms in patients with diabetes to health-care professionals is said to be responsible for limb amputation. While reasons for these delays have been investigated elsewhere, they are not well documented in Nigeria. This study explored the causes of delayed presentation in a Nigerian sample of patients with diabetic foot ulcers. Method The study followed an explorative qualitative design in which the lived experience of eight participants with diabetes were explored. The participants completed in-depth interviews which were digitally audio-recorded and transcribed verbatim. Data were analysed thematically using deductive reasoning. Results The study identified four themes which included knowledge and awareness of foot challenges, risk perception, health seeking triggers and behaviours and competing priority as the factors responsible for delay in presentation of diabetic foot complications. Conclusions Limited knowledge and awareness and negative health seeking behaviours including self-management and consultation of traditionalists were the major reasons for delays.
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Affiliation(s)
- Michael Opeoluwa Ogunlana
- Federal Medical Centre, Abeokuta, Nigeria.,College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Pragashnie Govender
- Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Olufemi Oyeleye Oyewole
- Department of Physiotherapy , Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | | | | | - Olubiyi F Adesina
- Unit of Endocrinology, Department of Internal Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Jabez Ariyo Akindipe
- Unit of Plastic Surgery, Department of Surgery, Federal Medical Centre, Abeokuta, Nigeria
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Sharma A, Baldi A, Kumar Sharma D. Impact of physical activity and cooking oil amongst diabetes with coexisting hypertension patients on economic cost and length of stay: A 1914 patient's observational study. Int J Clin Pract 2021; 75:e14163. [PMID: 33743546 DOI: 10.1111/ijcp.14163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
AIM OF THE STUDY The study aimed to investigate the impact of the patients' physical activity status and the type of cooking oil consumed by patients in their daily routine on glycaemic profile, lipid profile, the hypertensive profile of the patients, the length of stay and overall cost of the treatment. METHODS This is a prospective observational study. All the patients referred to the medicine department of the three different hospitals located in Moga, City Punjab, and those hospitalised due to diabetes mellitus (types I and II) with coexisting hypertension were asked to participate in the study. RESULTS The patients' mean age was found to be M = 53.85, SD = 11.54 years. Out of 1914 patients, 914 were male (47.8%); it was observed that the majority of the patients 525 (27.43%) in North India using butter or ghee-clarified butter as edible oil, followed by mustard oil 517 (27.01%) patients. About 345 (18.03%) of the patients consume soybean oil, whereas 226 (11.81%) of the patients like sunflower oil. CONCLUSION This study explored that cooking oil and physical activity are associated with length of stay in days and overall cost of the treatment, respectively. Our study results revealed that the type of oil compared with the treatment's overall cost was significant for olive oil, soybean oil and groundnut oil. The study revealed that moderate and low physical activity increases the length of stay compared to high physical activity. The consumption of olive oil as a regular food habit in daily routine decreases patients' length of stay with diabetes with coexisting hypertension when doing high physical activity but increases the overall cost of treatment.
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Affiliation(s)
- Amit Sharma
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
- Uttarakhand Technical University, Dehradun, Uttarakhand, India
| | - Ashish Baldi
- Department of Pharmaceutical Science and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Dinesh Kumar Sharma
- Department of Pharmaceutics, Himalayan Institute of Pharmacy and Research, Abdullapur, Uttarakhand, India
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Taebi M, Kariman N, Montazeri A, Alavi Majd H. Infertility Stigma: A Qualitative Study on Feelings and Experiences of Infertile Women. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2021; 15:189-196. [PMID: 34155865 PMCID: PMC8233927 DOI: 10.22074/ijfs.2021.139093.1039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/26/2020] [Indexed: 11/04/2022]
Abstract
Background: Infertility stigma is a phenomenon associated with various psychological and social tensions especially
for women. The stigma is associated with a feeling of shame and secrecy. The present study was aimed to explore the
concept of infertility stigma based on the experiences and perceptions of infertile women. Materials and Methods: This qualitative conventional content analysis study was conducted in Isfahan Fertility and
Infertility Center, Iran. Data were collected through in-depth interviews with 17 women who had primary infertility.
All the interviews were recorded, transcribed and analyzed according to the steps suggested by Graneheim and Lundman. The Standards for Reporting Qualitative Research (SRQR) checklist was followed for this research. Results: Eight hundred thirty-six initial codes were extracted from the interviews and divided into 25 sub-categories,
10 categories, and four themes. The themes included “stigma profile, self-stigma, defensive mechanism and balancing”. Stigma profile was perceived in the form of verbal, social and same sex stigma. Self-stigma was experienced
as negative feelings and devaluation. Defensive mechanism was formed from three categories of escaping from the
stigma, acceptance and infertility behind the mask. Two categories; empowered women and pressure levers, created a
balancing theme against the infertility stigma. Conclusion: Infertile women face social and self-stigma which threatens their psychosocial wellbeing and self-esteem.
They use defensive response mechanisms and social support to mitigate these effects. Education focused on coping
strategies might be helpful against infertility stigma.
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Affiliation(s)
- Mahboubeh Taebi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sharma A, Baldi A, Kumar Sharma D. Economic costs of hospitalisation and length of stay in diabetes with coexisting hypertension with correlation to laboratory investigations: Where does India stand? A 5-year ground report. Int J Clin Pract 2021; 75:e13990. [PMID: 33400350 DOI: 10.1111/ijcp.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The coexistence of diabetes mellitus (DM) and hypertension (HTN) worsens clinical outcomes and contributes to increased morbidity and mortality. OBJECTIVE This study aims to analyse the length of stay and healthcare costs by calculating the direct and indirect costs of diabetes with coexisting hypertension in North India. METHODS A prospective observational study was conducted at the medicine department of the three different hospitals. RESULTS The patients' mean age was (M = 53.8, SD = 11.5) years. Out of 1914 patients, 53.65% were female. Our study revealed that the median cost of medical supplies and equipment was 21.2 $. The median cost of dialysis was 47.5 $; the median cost of hospitalisation was 142.6 $. The treatment's median direct cost was 188.5 $, followed by the overall median cost of 295.6 $. The maximum overall cost of treatment was observed at 603.9 $. It was observed that maximum LOS was 14 days for patients having BPS between 140 and 159 mmHg and BPD between 110 and 119 mmHg, and minimum LOS was found 3.5 days. CONCLUSION The present study highlighted that diabetes coexisting hypertension poses a high-economic burden on patients. This study explored that highly significant result for BPS, BPD, FBS and HbA1 c, whereas the significant results were obtained when RBS is compared with LOS and treatment costs. Our study concluded that mean difference of 9.24 $ in patients having FBS was 261-290 mg/dL and >290 mg/dL. The LOS is increased by 6.57 days for patients with BPS between 140 and 159 mmHg compared with BPS between 180 and 209 and above mmHg, which lowers treatment costs by -21.31$.
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Affiliation(s)
- Amit Sharma
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
- Uttarakhand Technical University, Dehradun, Uttarakhand, India
| | - Ashish Baldi
- Department of Pharmaceutical Science and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Dinesh Kumar Sharma
- Department of Pharmaceutics, Himalayan Institute of Pharmacy and Research, Selakui, Uttarakhand, India
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Nwadiugwu MC, Bastola DR, Haas C, Russell D. Identifying Glycemic Variability in Diabetes Patient Cohorts and Evaluating Disease Outcomes. J Clin Med 2021; 10:jcm10071477. [PMID: 33918347 PMCID: PMC8038275 DOI: 10.3390/jcm10071477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022] Open
Abstract
Glycemic variability (GV) is an obstacle to effective blood glucose control and an autonomous risk factor for diabetes complications. We, therefore, explored sample data of patients with diabetes mellitus who maintained better amplitude of glycemic fluctuations and compared their disease outcomes with groups having poor control. A retrospective study was conducted using electronic data of patients having hemoglobin A1C (HbA1c) values with five recent time points from Think Whole Person Healthcare (TWPH). The control variability grid analysis (CVGA) plot and coefficient of variability (CV) were used to identify and cluster glycemic fluctuation. We selected important variables using LASSO. Chi-Square, Fisher’s exact test, Bonferroni chi-Square adjusted residual analysis, and multivariate Kruskal–Wallis tests were used to evaluate eventual disease outcomes. Patients with very high CV were strongly associated (p < 0.05) with disorders of lipoprotein (p = 0.0014), fluid, electrolyte, and acid–base balance (p = 0.0032), while those with low CV were statistically significant for factors influencing health status such as screening for other disorders (p = 0.0137), long-term (current) drug therapy (p = 0.0019), and screening for malignant neoplasms (p = 0.0072). Reducing glycemic variability may balance alterations in electrolytes and reduce differences in lipid profiles, which may assist in strategies for managing patients with diabetes mellitus.
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Affiliation(s)
- Martin C. Nwadiugwu
- Department of Biomedical Informatics, University of Nebraska at Omaha, Omaha, NE 68182, USA
- Correspondence: (M.C.N.); (D.R.B.)
| | - Dhundy R. Bastola
- Department of Biomedical Informatics, University of Nebraska at Omaha, Omaha, NE 68182, USA
- Correspondence: (M.C.N.); (D.R.B.)
| | - Christian Haas
- Department of Information Systems and Quantitative Analysis, University of Nebraska at Omaha, Omaha, NE 68182, USA;
| | - Doug Russell
- Think Whole Person Healthcare, Omaha, NE 68106, USA;
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Chen S, Chen X, Law S, Lucas H, Tang S, Long Q, Xue L, Wang Z. How and to what extent can pensions facilitate increased use of health services by older people: evidence from social pension expansion in rural China. BMC Health Serv Res 2020; 20:1008. [PMID: 33148248 PMCID: PMC7640495 DOI: 10.1186/s12913-020-05831-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this context, a significant practical issue is how to encourage older people to use the health services they need. This study aims to evaluate the effects of pensions on older adults' health service utilization, and estimate the level of pension required to influence such utilization. METHODS Using data from a nationally representative sample survey, the China Health and Retirement Longitudinal Study, we adopted a fuzzy regression discontinuity design and undertook segmented regression analysis. RESULTS It was found that a pension did encourage low-income people to use both outpatient (OR = 1.219, 95% 1.018-1.460) and inpatient services (OR = 1.269, 95% 1.020-1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037-1.407; OR = 1.206, 95% 1.024-1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094-1.932; OR = 1.456, 95% 1.079-1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote health service utilization were mainly located in the range 55-95 CNY (7.1-12.3 EUR or 8.0-13.8 USD). CONCLUSIONS A pension was found to have mixed effects on health service utilization for different income groups. Our study enriches existing evidence on the impact of pensions on healthcare-seeking behaviour and can be helpful in policy design and the formulation of improved models relating to pensions and healthcare utilisation.
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Affiliation(s)
- Shanquan Chen
- The School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Stephen Law
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Henry Lucas
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - Shenlan Tang
- Department of Population Health Science, Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Lei Xue
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Zheng Wang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
- Research Center for Healthcare Management, School of Economic and Management, Tsinghua University, Beijing, 100084, China.
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Prevalence and Associated Factors of Self-Treatment among the Elderly-A Comparative Study between Empty and Non-Empty Nesters in Shandong, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217880. [PMID: 33121139 PMCID: PMC7662221 DOI: 10.3390/ijerph17217880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022]
Abstract
(1) Objectives: With an aging society in China, self-treatment now plays an important role in health care among older adults, but it can be problematic. This study aims to explore and compare the self-treatment behavior among empty and non-empty nesters. (2) Methods: Using a multi-stage stratified random cluster sampling method, a total of 4366 elderly people aged 60 and above from Shandong Province, China, were enrolled in this study. Data were collected through a structured questionnaire. Binary logistic regression was used to analyze the associated factors of self-treatment. (3) Results: The prevalence of self-treatment in empty nesters was significantly lower than that in non-empty ones (74.0% vs. 83.3%). Binary logistic regression analysis showed that higher educational level and poorer self-rated economic status were negatively associated with self-treatment in empty nesters, while unemployed and urban and rural residents' basic medical insurance were positively associated with self-treatment in non-empty ones. (4) Conclusions: The study indicated that empty nesters had lower likelihood of self-treatment than non-empty ones. Empty nesters with better socioeconomic status were more likely to use self-treatment; by contrast, non-empty nesters with relatively poorer socioeconomic status were more inclined to self-treatment. Targeted interventions should be developed to maximize the effectiveness of self-treatment and reduce health risks.
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Rezaei S, Hajizadeh M, Ahmadi S, Ebrahimi M, Karami Matin B. Socioeconomic Inequality in Self-Medication in Iran: Cross-Sectional Analyses at the National and Subnational Levels. CLINICOECONOMICS AND OUTCOMES RESEARCH 2020; 12:411-421. [PMID: 32848432 PMCID: PMC7425653 DOI: 10.2147/ceor.s252244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Self-medication (SM) is a public health concern globally. This study aimed to measure socioeconomic inequality in SM and identify its main determinants among Iranian households. Methods A total of 38,859 households from the 2018 Household Income and Expenditure Survey (HIES) were included in the study. Data on SM, household size, age, gender and education status of the head of household, monthly household’s expenditures (as a proxy for socioeconomic status), health insurance coverage and living areas and provinces were obtained for the survey. The concentration curve and the normalized concentration index (Cn) were used to quantify the magnitude of socioeconomic inequality in SM among Iranian households. The Cn was decomposed to identify the main determinants of socioeconomic inequality in SM in Iran. Results The results indicated that 18.2% (95% confidence interval [CI]: 17.7% to 18.5%) of households in Iran had SM practice in the past month. The results suggested a higher concentration of SM among the rich households (Cn= 0.0466; 95% CI= 0.0321 to 0.0612) in Iran. The concentration of SM among high SES households was also found in urban (0.0311; 95% CI=0.0112 to 0.0510) and rural (= 0.0513; 95% CI=0.0301 to 0.0726) areas. SM was concentrated among the rich households in Tehran, Qom, Esfahan, Ardebil, Golestan, and Sistan and Baluchestan provinces. In contrast, a higher concentration of SM was found among the poor households in Semnan, North Khorasan, Kerman, Bushehr, and South Khorasan provinces. The decomposition revealed SES of household, itself, as the main contributing factor to the concentration of SM among the wealthy households. Conclusion This study demonstrated that SM is more concentrated among socioeconomically advantaged households in Iran. Thus, effective evidence-based interventions should be implemented to improve awareness about SM and its negative consequences. Further studies are required to investigate the consequences of SM practice among people.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Sina Ahmadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Ebrahimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Moulahoum H, Sanli S, Timur S, Zihnioglu F. Potential effect of carnosine encapsulated niosomes in bovine serum albumin modifications. Int J Biol Macromol 2019; 137:583-591. [DOI: 10.1016/j.ijbiomac.2019.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/29/2019] [Accepted: 07/01/2019] [Indexed: 12/18/2022]
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12
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Mohseni M, Azami-Aghdash S, Gareh Sheyklo S, Moosavi A, Nakhaee M, Pournaghi-Azar F, Rezapour A. Prevalence and Reasons of Self-Medication in Pregnant Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2018; 6:272-284. [PMID: 30465000 PMCID: PMC6226611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Given the importance of having valid information about the prevalence and reasons of self-medication among pregnant women for preventing self-medication during this period, this study aimed to systematically review and perform a meta-analysis on the prevalence and reasons of self-medication during pregnancy. METHODS This systematic review and meta-analysis was conducted in 2018 to estimate the overall self-medication prevalence based on the database sources PubMed, Scopus, Google Scholar, MagIran, IranMedex and SID. Required data were collected using keywords: medication, self-medication, over-the-counter, non-prescription, prevalence, etiology, and occurrence and pregnant. Descriptive and cross-sectional studies in English and Persian languages were included. There was no time limitation for search. R software was applied for meta-analysis. Random-effects model was applied to estimate the self-medication prevalence with 95% confidence interval. Q statistics and I2 were used to measure the heterogeneity. RESULTS Out of 490 retrieved articles, finally 13 studies were included in meta-analysis, 6 studies of which reported the cause of self-medication. The overall estimated prevalence of self-medication based on the random effect model was 32% (95% CI, 22% - 44%). The most important reasons of self-medication were previous experience of the disease. The most important group of disease in which patients self-medicated was anemia. Also, the most important group of medication was herbal. CONCLUSION The results of this study showed that the prevalence of self-medication among pregnant women was relatively high and required effective interventions to reduce and prevent self-medication among this group. Providing required information and raising awareness about complications resulting from self-medication, in particular herbal medicines and dietary supplements, should be taken into account.
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Affiliation(s)
- Mohammad Mohseni
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran;
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Sepideh Gareh Sheyklo
- Department of Obstetrics and Gynecology, Dezful University of Medical Sciences, Dezful, Iran;
| | - Ahmad Moosavi
- Department of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran;
| | - Majid Nakhaee
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran;
| | - Fatemeh Pournaghi-Azar
- Dental and Periodental Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran;
,Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Descriptions of self-treatment for the middle-aged and elderly in Shanxi, China. PLoS One 2018; 13:e0198554. [PMID: 29889852 PMCID: PMC5995374 DOI: 10.1371/journal.pone.0198554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 05/21/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Self-treatment is a widespread practice among patients with common symptoms and ailments; it is necessary to explore multiple aspects of it. Notably, there is little research into self-treatment among middle-aged and elderly people, who are more likely to fall ill. Our goals are to provide a comprehensive description of self-treatment and explore associated factors with insurance utilization and expenditures among the middle-aged and elderly populations in China. METHODS A survey was conducted in July 2016 in Shanxi, China. A stratified sampling scheme was applied to achieve representativeness. A total of 972 subjects were surveyed. Descriptive statistics, t- and Chi-squared tests, multivariate logistic regression, and multivariate linear regression were utilized. RESULTS In our study, 772 (79.4%) of the surveyed subjects self-treated during the previous twelve months. Among them, 253 (32.8%) used health insurance. Subjects' characteristics were associated with insurance utilization and expenditures for self-treatment. Total cost was positively associated with insurance utilization. The subjects with a junior high education (p-value < 0.001, aOR = 0.049) and senior high education (p-value = 0.020, aOR = 0.146) had a lower probability of using insurance. For both total costs and out-of-pocket costs, subjects who were 51 to 60 years old had lower costs. The subjects who were seriously sick and had a primary school education, as well as enterprise occupations, had higher costs. Self-treatment times were also positively associated with costs. Finally, it was found that subjects who didn't use insurance had lower total costs. CONCLUSIONS The prevalence of self-treatment was high (79.4%). Some characteristics were associated with insurance utilization and expenditures in self-treatment. Our results may be helpful for policy interventions, which are needed to further improve the effectiveness of health insurance in China.
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Zhao Y, Ma S. Observations on the Prevalence, Characteristics, and Effects of Self-Treatment. Front Public Health 2016; 4:69. [PMID: 27148515 PMCID: PMC4834428 DOI: 10.3389/fpubh.2016.00069] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/01/2016] [Indexed: 12/04/2022] Open
Abstract
Aims When facing illness, a person may choose self-treatment as an alternative to hospital (and primary care)-based treatment. Despite its important role in health care, the study on self-treatment remains limited. The goal is to collectively report the observations in the literature on the prevalence, characteristics, and effects of self-treatment. Methods Databases (Medline/PubMed and Google Scholar) were searched. Articles were scrutinized for country of origin, sample size, recall period, prevalence, associated factors, etc. Results Published studies have reported that in some regions, the prevalence of self-treatment is high and varies across illness conditions and treatment approaches. Self-medication is the most popular self-treatment approach. Multiple regional, demographic, personal, cultural, and religious factors have been implicated in the pursuit of self-treatment. In addition, accessibility of health care also plays a role. In general, self-treatment has a positive clinical and financial effect. However, there have been concerns on abuse and possible negative effects. Conclusion This article reviews observations made in recent studies on several important aspects of self-treatment. Comprehensive and systematic study is still lacking. Interventions are needed to solve several problems associated with self-treatment.
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Affiliation(s)
- Yinjun Zhao
- Department of Biostatistics, Yale University , New Haven, CT , USA
| | - Shuangge Ma
- Department of Biostatistics, Yale University , New Haven, CT , USA
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Karimi Moonaghi H, Namdar Areshtanab H, Joibari L, Arshadi Bostanabad M, McDonald H. Struggling towards diagnosis: experiences of Iranian diabetes. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e16547. [PMID: 25237566 PMCID: PMC4166085 DOI: 10.5812/ircmj.16547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/03/2014] [Accepted: 03/23/2014] [Indexed: 11/16/2022]
Abstract
Background: Healthcare-seeking behavior is one of the factors determining the uptake and outcome of healthcare. However, few studies have discussed how and why diabetics seek healthcare assistance before meeting a physician. Objectives: In this study, we explored the subjective experiences of healthcare-seeking behavior among Iranian patients with type 2 diabetes mellitus. Patients and Methods: A qualitative approach was adopted using a conventional content analysis of semi-structured interviews carried out in the Diabetes Association in Tabriz (Iran) with 15 participants suffering from type 2 diabetes. Participants were recruited by the purposeful sampling method. Results: Five themes emerged from the study: 1) warning by physical signs; 2) personal processing; 3) self-remedy and its outcomes; 4) seeking information, and; 5) diagnosis and verification of information by healthcare staff. Conclusions: Individual social context plays an important role in the decision-making process when seeking healthcare for diabetes. The results of this study can be utilized by healthcare providers to facilitate interventions to increase diabetics’ active involvement in their healthcare, and encourage a wider knowledge of its symptoms and outcomes to facilitate appropriate healthcare-seeking and service use.
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Affiliation(s)
- Hossein Karimi Moonaghi
- Department of Medical Surgery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hossein Namdar Areshtanab
- Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding Author: Hossein Namdar Areshtanab, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Ebn-e-Sina Square, Mashhad, IR Iran. Tel: +98-5118591511, Fax: +98-5118597313 , E-mail:
| | - Leila Joibari
- Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, IR Iran
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Almaatouq MA, Al-Arouj M, Amod A, Assaad-Khalil SH, Assaad SN, Azar ST, Esmat K, Hassoun AAK, Jarrah N, Zatari S. Barriers to the delivery of optimal antidiabetic therapy in the Middle East and Africa. Int J Clin Pract 2014; 68:503-11. [PMID: 24471972 DOI: 10.1111/ijcp.12342] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes is increasing worldwide, but developing nations will bear a disproportionate share of this burden. Countries in the Middle East and Africa are in a state of transition, where marked disparities of income and access to education and healthcare exist, and where the relatively young populations are being exposed increasingly to processes of urbanisation and adverse changes in diet that are fuelling the diabetes epidemic. Optimising diabetes care in these nations is crucial, to minimise the future burden of complications of diabetes. METHODS We have reviewed the barriers to effective diabetes care with special relevance to countries in this region. RESULTS The effects of antidiabetic treatments themselves are unlikely to differ importantly in the region compared with elsewhere, but economic inequalities within countries restrict access to newer treatments, in particular. Values relating to family life and religion are important modifiers of the physician-patient interaction. Also, a lack of understanding of diabetes and its treatments by both physicians and patients requires more and better diabetes education, delivered by suitably qualified health educators. Finally, sub-optimal processes for delivery of care have contributed to a lack of proper provision of testing and follow-up of patients in many countries. CONCLUSION Important barriers to the delivery of optimal diabetes care exist in the Middle East and Africa.
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Affiliation(s)
- M A Almaatouq
- King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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Patients’ and Health Professionals’ Views on Caring in Diabetes Disease. Nurs Midwifery Stud 2012. [DOI: 10.5812/nms.7911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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