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Adzakpah G, Mensah NK, Boadu RO, Kissi J, Dogbe M, Wadere M, Senyah D, Agyarkoaa M, Mensah L, Appiah-Acheampong A. Determining patients' willingness to pay for telemedicine services and associated factors amidst fear of coronavirus disease 2019 (COVID-19) in Ghana. Heliyon 2023; 9:e19191. [PMID: 37649839 PMCID: PMC10462837 DOI: 10.1016/j.heliyon.2023.e19191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Godwin Adzakpah
- Department of Health Information Management, College of Health and Allied Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Nathan Kumasenu Mensah
- Department of Health Information Management, College of Health and Allied Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard Okyere Boadu
- Department of Health Information Management, College of Health and Allied Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jonathan Kissi
- Department of Health Information Management, College of Health and Allied Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Dogbe
- Health Information Management Department, Akuse Government Hospital, Akuse, Eastern Region, Ghana
| | - Michael Wadere
- Health Information Management Department, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Dela Senyah
- Health Information Management Department, Abura Dunkwa District Hospital, Abura Dunkwa, Ghana
| | - Mavis Agyarkoaa
- Health Information Management Department, Wenchi Health Centre, Wenchi, Ghana
| | - Lawrencia Mensah
- Health Information Management Department, University of Cape Coast, Cape Coast, Ghana
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Chen S, Kuhn M, Prettner K, Yu F, Yang T, Bärnighausen T, Bloom DE, Wang C. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study. Lancet Glob Health 2023; 11:e1183-e1193. [PMID: 37474226 PMCID: PMC10369014 DOI: 10.1016/s2214-109x(23)00217-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and imposes a substantial economic burden. Gaining a thorough understanding of the economic implications of COPD is an important prerequisite for sound, evidence-based policy making. We aimed to estimate the macroeconomic burden of COPD for each country and establish its distribution across world regions. METHODS In this health-augmented macroeconomic modelling study we estimated the macroeconomic burden of COPD for 204 countries and territories over the period 2020-50. The model accounted for (1) the effect of COPD mortality and morbidity on labour supply, (2) age and sex specific differences in education and work experience among those affected by COPD, and (3) the impact of COPD treatment costs on physical capital accumulation. We obtained data from various public sources including the Global Burden of Disease Study 2019, the World Bank database, and the literature. The macroeconomic burden of COPD was assessed by comparing gross domestic product (GDP) between a scenario projecting disease prevalence based on current estimates and a counterfactual scenario with zero COPD prevalence from 2020 to 2050. FINDINGS Our findings suggest that COPD will cost the world economy INT$4·326 trillion (uncertainty interval 3·327-5·516; at constant 2017 prices) in 2020-50. This economic effect is equivalent to a yearly tax of 0·111% (0·085-0·141) on global GDP. China and the USA face the largest economic burdens from COPD, accounting for INT$1·363 trillion (uncertainty interval 1·034-1·801) and INT$1·037 trillion (0·868-1·175), respectively. INTERPRETATION The macroeconomic burden of COPD is large and unequally distributed across countries, world regions, and income levels. Our study stresses the urgent need to invest in global efforts to curb the health and economic burdens of COPD. Investments in effective interventions against COPD do not represent a burden but could instead provide substantial economic returns in the foreseeable future. FUNDING Alexander von Humboldt Foundation, National Natural Science Foundation of China, CAMS Innovation Fund for Medical Science, Chinese Academy of Engineering project, Chinese Academy of Medical Sciences and Peking Union Medical College project, and Horizon Europe. TRANSLATIONS For the Chinese and German translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Simiao Chen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Michael Kuhn
- International Institute for Applied Systems Analysis, Laxenburg, Austria; Wittgenstein Centre, Vienna, Austria
| | - Klaus Prettner
- Vienna University of Economics and Business, Department of Economics, Vienna, Austria
| | - Fengyun Yu
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chen Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China; Chinese Academy of Engineering, Beijing, China.
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Safari H, Poder TG, Afshari S, Nahvijou A, Arab-Zozani M, Moradi N, Ameri H. Determination of a cost-effectiveness threshold for cancer interventions in Iran. Front Oncol 2022; 12:1039589. [PMID: 36578935 PMCID: PMC9791211 DOI: 10.3389/fonc.2022.1039589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Background and objectives The estimation of a cost- Effectiveness (CE) threshold from the perspective of those who have experienced a life-threatening disease can provide empirical evidence for health policy makers to make the best allocation decisions on limited resources. The aim of the current study was to empirically determine the CE threshold for cancer interventions from the perspective of cancer patients in Iran. Methods A composite time trade-off (cTTO) task for deriving quality adjusted life-year (QALY) and a double-bounded dichotomous choice (DBDC) approach followed by open-ended question for examining patients' willingness-to-pay were performed. A nationally representative sample of 580 cancer patients was recruited from the largest governmental cancer centers in Iran between June 2021 and January 2022, and data were gathered using face-to-face interviews. The CE threshold was calculated using the nonparametric Turnbull model and parametric interval-censored Weibull regression model. Furthermore, the factors that affect the CE threshold were determined using the parametric model. Results The estimated CE threshold using the nonparametric Turnbull model and parametric interval-censored Weibull regression model was IRR 440,410,000 (USD 10,485.95) and IRR 595,280,000 (USD 14,173.33) per QALY, respectively. Gender, age, education, income, type of cancer, and current treatment status were significantly associated with the estimated CE threshold. Conclusions The value of parametric model-based threshold in this study was 1.98 times the Iranian GDP per capita, which was lower than the CE threshold value recommended by the WHO (i.e., 3 times the GDP per capita) for low-and middle-income countries.
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Affiliation(s)
- Hossein Safari
- Health Promotion Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Thomas G. Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, QC, Canada,Centre de recherche de l’Institut universitaire en santé mentale de Montréal, CIUSSS de l’Est de l’île de Montréal, Montreal, QC, Canada
| | - Somayeh Afshari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Nasrin Moradi
- Department of Health Management and Economics, School of Public Health, Iran University of Medical Science, Tehran, Iran
| | - Hosein Ameri
- Health Policy and Management Research Center, Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,*Correspondence: Hosein Ameri,
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Chua V, Koh JH, Koh CHG, Tyagi S. The Willingness to Pay for Telemedicine Among Patients With Chronic Diseases: Systematic Review. J Med Internet Res 2022; 24:e33372. [PMID: 35416779 PMCID: PMC9047785 DOI: 10.2196/33372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/16/2021] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background Telemedicine is increasingly being leveraged, as the need for remote access to health care has been driven by the rising chronic disease incidence and the COVID-19 pandemic. It is also important to understand patients’ willingness to pay (WTP) for telemedicine and the factors contributing toward it, as this knowledge may inform health policy planning processes, such as resource allocation or the development of a pricing strategy for telemedicine services. Currently, most of the published literature is focused on cost-effectiveness analysis findings, which guide health care financing from the health system’s perspective. However, there is limited exploration of the WTP from a patient’s perspective, despite it being pertinent to the sustainability of telemedicine interventions. Objective To address this gap in research, this study aims to conduct a systematic review to describe the WTP for telemedicine interventions and to identify the factors influencing WTP among patients with chronic diseases in high-income settings. Methods We systematically searched 4 databases (PubMed, PsycINFO, Embase, and EconLit). A total of 2 authors were involved in the appraisal. Studies were included if they reported the WTP amounts or identified the factors associated with patients’ WTP, involved patients aged ≥18 years who were diagnosed with chronic diseases, and were from high-income settings. Results A total of 11 studies from 7 countries met this study’s inclusion criteria. The proportion of people willing to pay for telemedicine ranged from 19% to 70% across the studies, whereas the values for WTP amounts ranged from US $0.89 to US $821.25. We found a statistically significant correlation of age and distance to a preferred health facility with the WTP for telemedicine. Higher age was associated with a lower WTP, whereas longer travel distance was associated with a higher WTP. Conclusions On the basis of our findings, the following are recommendations that may enhance the WTP: exposure to the telemedicine intervention before assessing the WTP, the lowering of telemedicine costs, and the provision of patient education to raise awareness on telemedicine’s benefits and address patients’ concerns. In addition, we recommend that future research be directed at standardizing the reporting of WTP studies with the adoption of a common metric for WTP amounts, which may facilitate the generalization of findings and effect estimates.
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Affiliation(s)
- Valerie Chua
- Office of Healthcare Transformation, Ministry of Health, Singapore, Singapore
| | - Jin Hean Koh
- Office of Healthcare Transformation, Ministry of Health, Singapore, Singapore
| | | | - Shilpa Tyagi
- Office of Healthcare Transformation, Ministry of Health, Singapore, Singapore
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Cheng P, Xinyu L, Sidai G, Yubing Q. Study on Willingness to Pay and Impact Mechanism of Gutter Oil Treatment: Taking Urban Residents in Sichuan Province as an Example. Front Psychol 2021; 12:711218. [PMID: 34858250 PMCID: PMC8631812 DOI: 10.3389/fpsyg.2021.711218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/25/2021] [Indexed: 12/03/2022] Open
Abstract
"Gutter oil" is a term for the practice of recycling used waste oil from restaurant fryers, sinks, and even slaughterhouses and sewers, and has been a major food safety and sanitation issue in China for many years. However, with proper treatment, these issues can be mitigated, turning large amounts of waste product into valuable resources and conserving energy resources. Based on this questionnaire survey conducted in the cities of Chengdu and Mianyang in Sichuan, China, this paper uses the value evaluation method to measure urban residents' willingness to pay for the treatment of gutter oil, and explores the factors and path influencing residents' willingness to pay based on the extended theory of planned behavior. The results of this study affirms the validity and universality of the Theory of Planned Behavior. Behavioral attitude, perceived behavioral control, and subjective norms have a direct positive impact on their willingness to pay. Risk perception and past experience indirectly affect residents' willingness to pay for gutter oil through the intermediary variable of behavioral attitude, which means that the public's risk awareness can be improved by vigorously publicizing the harmful effects of gutter oil, thereby also increasing acceptance toward gutter oil treatment. As an intermediary variable, subjective norms have a significant indirect effect on the impact path of past experience on willingness to pay, which reflects the significant influence of subjective norms such as reference group and environment. The results show that urban residents have a higher willingness to pay for the treatment of gutter oil. The mean willingness to pay is 7.75 RMB per month per capita.
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Affiliation(s)
| | | | - Guo Sidai
- School of Economics and Management, Southwest University of Science and Technology, Mianyang, China
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Burge AT, Holland AE, McDonald CF, Hill CJ, Lee AL, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahhama A, Gillies R, Mahald A. "Willingness to Pay": The Value Attributed to Program Location by Pulmonary Rehabilitation Participants. COPD 2021; 18:281-287. [PMID: 34060968 DOI: 10.1080/15412555.2021.1924127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The "contingent valuation" method is used to quantify the value of services not available in traditional markets, by assessing the monetary value an individual ascribes to the benefit provided by an intervention. The aim of this study was to determine preferences for home or center-based pulmonary rehabilitation for participants with chronic obstructive pulmonary disease (COPD) using the "willingness to pay" (WTP) approach, the most widely used technique to elicit strengths of individual preferences. This is a secondary analysis of a randomized controlled equivalence trial comparing center-based and home-based pulmonary rehabilitation. At their final session, participants were asked to nominate the maximum that they would be willing to pay to undertake home-based pulmonary rehabilitation in preference to a center-based program. Regression analyses were used to investigate relationships between participant features and WTP values. Data were available for 141/163 eligible study participants (mean age 69 [SD 10] years, n = 82 female). In order to undertake home-based pulmonary rehabilitation in preference to a conventional center-based program, participants were willing to pay was mean $AUD176 (SD 255) (median $83 [IQR 0 to 244]). No significant difference for WTP values was observed between groups (p = 0.98). A WTP value above zero was related to home ownership (odds ratio [OR] 2.95, p = 0.02) and worse baseline SF-36 physical component score (OR 0.94, p = 0.02). This preliminary evidence for WTP in the context of pulmonary rehabilitation indicated the need for further exploration of preferences for treatment location in people with COPD to inform new models of service delivery.
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Affiliation(s)
- Angela T Burge
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Catherine J Hill
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Annemarie L Lee
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Narelle S Cox
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Australia
| | | | - Caroline Nicolson
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Paul O'Halloran
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Aroub Lahhama
- Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Rebecca Gillies
- Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Ajay Mahald
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
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Cheng HC, Chang K, Shen E, Luo KS, Ying YH. Risk Factors and Behaviours of Schoolchildren with Myopia in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061967. [PMID: 32192125 PMCID: PMC7142869 DOI: 10.3390/ijerph17061967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
Abstract
Importance: Because of the high prevalence of myopia in Taiwan, understanding the risk factors for its development and progression is important to public health. Background: This study investigated the risk factors for myopia and their influence on the progression of myopia in schoolchildren in Taiwan. Design: Patients’ clinical records were obtained retrospectively from ophthalmologists. Questionnaires were given to collect demographic information, family background, hours spent on daily activities, myopia progression, and treatment methods. Participants: From a regional medical hospital in northern Taiwan, 522 schoolchildren with myopia participated in the study. Written informed consent was obtained from participants of legal age or the parents or legal guardians of younger children. Methods: Multivariable regression analyses were performed. Myopia measured in cycloplegic spherical equivalent (SE) was analysed, controlling for patients’ family and demographic information as well as their daily activity behaviours. Main Outcome Results: Children with high myopic parents were more myopic. Earlier onset age of myopia was associated with a higher level of myopia and greater annual myopic progression. Children reporting longer time usage of electronic devices had greater progression of myopia. Boys tended to be more myopic than girls. Lower levels of myopia were associated with more outdoor activities, and better vision care knowledge in children and parents. Conclusions and Relevance: In addition to genetics, education and environment can influence the development of myopia. Health policies for schoolchildren should promote protective activities and vision care knowledge at a young age, to protect the eyesight of schoolchildren.
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Affiliation(s)
- Han-Chih Cheng
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
- Department of Ophthalmology, Tzu-chi University, Huanlien County 907, Taiwan
| | - Koyin Chang
- Dept. of Healthcare Information and Management, Ming Chuan University, Taoyuan City 333, Taiwan
- Correspondence: (K.C.); (Y.-H.Y.); Tel.: +886-2-7749-3291 (K.C.)
| | - Elizabeth Shen
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
- Department of Ophthalmology, Tzu-chi University, Huanlien County 907, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Medical College, National Taiwan University, Taipei 100, Taiwan
| | - Kai-Shin Luo
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
| | - Yung-Hsiang Ying
- Department of Business Administration, National Taiwan Normal University, Taipei 106, Taiwan
- Correspondence: (K.C.); (Y.-H.Y.); Tel.: +886-2-7749-3291 (K.C.)
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Emilija N, Aleksandar N, Ruža S, Tijana B, Veselin M, Jelena M. Model for Developing a Health-Related Quality of Life Questionnaire for Chronic Obstructive Pulmonary Disease. Can Respir J 2018; 2018:6450962. [PMID: 29854031 PMCID: PMC5954916 DOI: 10.1155/2018/6450962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/20/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction The St. George's Respiratory Questionnaire (SGRQ), Modified Medical Research Council (mMRC) Dyspnea Scale, Hospital Anxiety and Depression Scale (HADS), and general health questionnaire (SF-36) are widely used for chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). Aim We examined the reliability and validity of a modified questionnaire (MQ) to create a model for assessing the health-related quality of life (HRQOL) in COPD. Method In total, 132 COPD patients completed the MQ. Lung function, smoking index, and exacerbation frequency were measured. Cronbach's α coefficient of correlation, standard deviation, and multifactorial nonlinear regression analysis were used to verify the internal validity of the MQ and to develop the mathematical model. Results Female (63) patients had lesser airway obstruction than, and exacerbation frequency similar to that of, male patients. Exacerbation frequency significantly correlated with spirometry parameters in female patients. The MQ total score achieved high internal consistency (Cronbach's α = 0.89) and showed significant correlations with exacerbation frequency, smoking habit, and spirometry parameters in male patients (p < 0.005). Conclusion The HRQOL questionnaire was shown to be a good indicator of the health status of COPD patients. The mathematical model easily and precisely confirmed the score of HRQOL questionnaire.
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Affiliation(s)
- Nikolić Emilija
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | | | - Stević Ruža
- Faculty of Medicine, University of Belgarde, 11000 Belgrade, Serbia
| | - Brandmajer Tijana
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | - Mićanović Veselin
- Faculty of Philosophy, University of Montenegro, 81000 Podgorica, Montenegro
| | - Mašnić Jelena
- Faculty of Philosophy, University of Montenegro, 81000 Podgorica, Montenegro
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Puteh SEW, Ahmad SNA, Aizuddin AN, Zainal R, Ismail R. Patients' willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation. ASIA PACIFIC FAMILY MEDICINE 2017; 16:5. [PMID: 28392749 PMCID: PMC5379617 DOI: 10.1186/s12930-017-0035-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 03/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population. METHODS A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses. RESULTS Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP. CONCLUSION The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.
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Affiliation(s)
- Sharifa Ezat Wan Puteh
- Faculty of Medicine, Department of Community Health, University Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Siti Nurul Akma Ahmad
- Health Administration, Faculty of Business Management, Universiti Teknologi MARA, Puncak Alam, Selangor Malaysia
| | - Azimatun Noor Aizuddin
- Faculty of Medicine, Department of Community Health, University Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Ramli Zainal
- Institute for Health Systems Research, Ministry of Health, Kuala Lumpur, Malaysia
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