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Socioeconomic Impact of Hospitalization Expenditure for Treatment of Noncommunicable Diseases in India: A Repeated Cross-Sectional Analysis of National Sample Survey Data, 2004 to 2018. Value Health Reg Issues 2021; 24:199-213. [PMID: 33845450 DOI: 10.1016/j.vhri.2020.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/17/2020] [Accepted: 12/27/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This article explores the consequences of hospitalization expenditure on noncommunicable diseases (NCD) and its impact on out-of-pocket expenditure (OOPE), catastrophic health expenditure, impoverishment, and hardship financing of households in India. METHODS Data on hospitalized cases of NCDs from the 3 rounds of National Sample Surveys (NSS) (2004, 2014, 2018) were used. Bivariate and multivariate analyses were conducted to investigate the socioeconomic differentials of the impact of OOPE on catastrophic health expenditure, impoverishment, and exposure to hardship financing. RESULTS Rural households had greater exposure to catastrophic health expenditure but urban households had higher risk of impoverishment due to OOPE. Older patients (aged ≥60 years) had the highest hospitalization rate per 100 000, including increase in average healthcare expenditure from 2004 to 2018. At 10% and 30% thresholds, 50% and 25% of the households, respectively, faced catastrophic health expenditure across all the 3 rounds. Due to OOPE on hospitaliation treatment for NCDs, about 3.8%, 7.4% and 4.8% of households fell below poverty line, and percentage shortfall in income for the population from the poverty line was 3%, 4.9% and 3%, in 2004, 2014 and 2018 respectively. Percentage of households facing hardship financing reduced from 49.2% in 2004 to 24.4% 2014 and 12.7% in 2018. CONCLUSION OOPE by households are still very high and hence the higher effects of CHE, impoverishment and exposure to hardship financing due to health expenditure in India. This study proposes that along with increase in budgetary allocations for healthcare, the government should develop suitable policies to expand the effectiveness of government-sponsored health insurance, such as developing a specific NCD service package to be included in the health insurance program.
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Reveco R, Velásquez M, Bustos L, Goyenechea M, Bachelet V. Determining the Operating Costs of a Medical Surveillance Program for Copper Miners Exposed to High Altitude-Induced Chronic Intermittent Hypoxia in Chile Using a Combination of Microcosting and Time-Driven Activity-Based Costing. Value Health Reg Issues 2019; 20:115-121. [PMID: 31255923 DOI: 10.1016/j.vhri.2019.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/25/2018] [Accepted: 01/15/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Copper mining installations in Chile use a large number of workers who do their jobs at high altitudes, exposing them to the conditions of chronic intermittent hypobaric hypoxia. The Chilean Safety Association implements the surveillance program. OBJECTIVE This organization, under the sponsorship of the Chilean Superintendency of Social Security, was interested in determining the costs involved in this program to support its decision-making processes and to improve its performance. METHODS Direct operating costs of the Hypoxia Medical Surveillance Program were determined through on-site surveys applied to the organization's local agencies in charge. The microcosting method was used, quantifying personnel costs, consumables, and equipment and overhead costs. Time-driven activity-based costing was partially adapted for the allocation of personnel and equipment costs. Costs concerning activities, groups of activities and items, and average cost per exposed worker were determined. RESULTS The annual costs of the program were $127 299.58. The highest costs corresponded to the assessment activities, which were $89 192.13, representing 60.06% of the total. The labor factor costs were $77 568.50, which represents 60.93% of the total. The average cost per worker in the program is $21.17. CONCLUSIONS The partial adaptation of the time-driven activity-based costing method in combination with the microcosting method provides a suitable solution to determine the total costs of running a healthcare program of this kind. The information generated by this study will aid in the decision-making and management processes of the Hypoxia Medical Surveillance Program.
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Affiliation(s)
- Roberto Reveco
- Departamento de Administración y Economía, Universidad de La Frontera, Temuco, Chile; Centro de Excelencia "Capacitación, Investigación y Gestión para la Salud basada en Evidencias", Universidad de La Frontera, Temuco, Chile.
| | - Mónica Velásquez
- Centro de Excelencia "Capacitación, Investigación y Gestión para la Salud basada en Evidencias", Universidad de La Frontera, Temuco, Chile; Departamento de Especialidades Médicas, Universidad de La Frontera, Temuco, Chile
| | - Luis Bustos
- Centro de Excelencia "Capacitación, Investigación y Gestión para la Salud basada en Evidencias", Universidad de La Frontera, Temuco, Chile; Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile
| | | | - Vivienne Bachelet
- Medwave Estudios, Santiago, Chile; Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
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Vu TTM, Le TV, Dang AK, Nguyen LH, Nguyen BC, Tran BX, Latkin CA, Ho CSH, Ho RCM. Socioeconomic Vulnerability to Depressive Symptoms in Patients with Chronic Hepatitis B. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020255. [PMID: 30658423 PMCID: PMC6352008 DOI: 10.3390/ijerph16020255] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/12/2019] [Accepted: 01/13/2019] [Indexed: 12/17/2022]
Abstract
Depression is considered one of the most prevalent psychiatric disorders among patients with hepatitis B virus (HBV)-related liver disease and has adverse effects on the disease progression. However, there is a scarcity of studies contributing to the assessement of depression in hepatitis B patients. There is also little research into risk factors, particularly underlying socio-economic factors in Vietnam where the prevalence of hepatitis B is high. This study aimed to examine depression and identify whether differences in socio-economic status is related to the level of depression amongst chronic hepatitis B patients. A cross-sectional study was conducted on 298 patients with chronic hepatitis B at The Chronic Hepatitis Clinic in the Viet-Tiep Hospital, Hai Phong, Vietnam. The Patient Health Questionnaire-9 (PHQ-9) and EuroQol-5 dimensions-5 levels (EQ-5D-5L) were used to assess the severity of depression and health-related quality of life (HRQOL). Of chronic hepatitis B patients, 37.5% experienced depressive symptoms and most of them suffered minimal depressive symptoms (31.4%). According to the result of the multivariate logistic regression model, we found that higher age, lower income level, unemployement, living with spouse/partners were positively associated with having depression. Furthermore, having physical health problems and lower health-related quality of life were also related to a higher risk of depression. We recommend family support, financial support and active participation in consultation should be conducted during treatment to improve the quality of life and the emotional state of HBV patients.
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Affiliation(s)
| | - Thieu Van Le
- Viet-Tiep Friendship Hospital, Hai Phong 180000, Vietnam.
| | - Anh Kim Dang
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
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Pham T, Bui L, Kim G, Hoang D, Tran T, Hoang M. Cancers in Vietnam-Burden and Control Efforts: A Narrative Scoping Review. Cancer Control 2019; 26:1073274819863802. [PMID: 31319695 PMCID: PMC6643189 DOI: 10.1177/1073274819863802] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/04/2019] [Accepted: 06/18/2019] [Indexed: 01/19/2023] Open
Abstract
Although the burden of cancer is rapidly growing in Vietnam, there was no up-to-date review that describes cancer burden and control in Vietnam throughout the literature. By identifying various risk factors, means of prevention, and methods for early detection, this review seeks to systematically summarize the evidence for the future planning and management of cancer occurrence in Vietnam. Additionally, this report aims to identify improvements which are necessary for the treatment and palliative care of patients with cancer in Vietnam. We employed a hybrid approach including both a scoping review and narrative synthesis for this study. Information was identified, extracted, and charted from various sources, which include international and domestically published studies, in addition to gray literature. Our results illustrate that the burden of cancer in Vietnam has tripled in the past 30 years, and this situation could be partly explained by the growing prevalence of both old and new risk factors. Besides hepatitis B virus, various other important risk factors such as human papilloma virus, tobacco usage, physical inactivity, and improper diets are still not under control in Vietnam. There is presently a lack of national cancer screening programs, and the capacity of cancer care services could not maintain pace with the demands of a rapidly increasing Vietnamese population. Overall, policy frameworks for cancer control in Vietnam are in place, but there is still a lack of proper financing and governing models necessary to support a sustainable program. In conclusion, Cancer and its associated consequences are both persistent and emerging problems in Vietnam, and the results of cancer control programs are limited. A comprehensive and evidence-based approach toward the prevention and treatment of cancer should be the future direction for Vietnam.
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Affiliation(s)
- Tung Pham
- Department of Physiology, Hanoi Medical University, Hanoi,
Vietnam
- Center for Population Health Science, Hanoi University of Public
Health, Hanoi, Vietnam
| | - Linh Bui
- Center for Population Health Science, Hanoi University of Public
Health, Hanoi, Vietnam
| | - Giang Kim
- Department of Health Education, Hanoi Medical University, Hanoi,
Vietnam
| | - Dong Hoang
- Vietnam National Cancer Institute, National Cancer Hospital, Hanoi,
Vietnam
| | - Thuan Tran
- Vietnam National Cancer Institute, National Cancer Hospital, Hanoi,
Vietnam
| | - Minh Hoang
- Department of Health Economics, Hanoi University of Public Health,
Hanoi, Vietnam
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Direct Hospitalization Cost of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010088. [PMID: 30598020 PMCID: PMC6339007 DOI: 10.3390/ijerph16010088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/22/2018] [Accepted: 12/27/2018] [Indexed: 12/02/2022]
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have been found to contribute, predominantly, to increasing costs of COPD—a major public health issue. This study aimed to fill the gap in literature concerning costs of AECOPD in Vietnam, by examining the direct cost of AECOPD hospitalization and determining potentially associated factors. A cross-sectional study was conducted at the Respiratory Center of Bach Mai Hospital, Hanoi. A total of 57 participants were selected. Information regarding sociodemographic features, clinical characteristics, and hospitalization costs were collected. A multivariate generalized linear regression model was utilized to determine the factors associated with hospitalization costs. The mean total and daily hospitalization cost were 18.3 million VND (SD = 12.9) and 2.5 million VND (SD = 3.2), respectively. Medication cost accounted for 53.9% of hospitalization cost (from 44.0% in the Global Initiative for Chronic Obstructive Lung Disease Classification A (GOLD A) to 55.3% in GOLD C). Patients having GOLD D COPD (Coef. = 5.78; 95% CI = 0.73–10.83), higher age (Coef. = 0.37; 95% CI = 0.13–0.61), and higher duration of hospitalization (Coef. = 1.91; 95% CI = 1.28–2.53) had higher hospitalization costs (p < 0.05). This study suggested that interventions to screen COPD patients as well as provide timely treatment should be conducted widely in the community in order to avoid any unnecessary hospitalization cost, consequently reducing the economic burden of COPD.
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Ha NT, Le NH, Khanal V, Moorin R. Multimorbidity and its social determinants among older people in southern provinces, Vietnam. Int J Equity Health 2015; 14:50. [PMID: 26024877 PMCID: PMC4459670 DOI: 10.1186/s12939-015-0177-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 05/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Developing countries are poorly equipped for health issues related to ageing populations making multimorbidity challenging. As in Vietnam the focus tends to be on single conditions. Hence little is known about burden of multimorbidity. This study aimed to examine the prevalence and the determinants of multimorbidity among older people in Southern Vietnam. METHODS A cross-sectional study was conducted in two provinces of Southern Vietnam with a sample of 2400 people aged 60 years and older. The presence of chronic disease was ascertained by medical examination done by physicians at commune health stations. Information on social and demographic factors was collected using structured questionnaire. Univariate and multivariable logistic regression analyses were used to examine the factors associated with multimorbidity. RESULTS Nearly 40 % of older people had multimorbidity. Currently not working, and healthcare utilisation were associated with higher prevalence of multimorbidity. Living in urban areas and being literate were associated with lower prevalence of multimorbidity. CONCLUSION The study found a high burden of multimorbidity among illiterate, especially those living in rural areas. This highlights the need for targeted community based programs aimed at reducing the burden of chronic disease.
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Affiliation(s)
- Ninh Thi Ha
- Institute of Public Health, 159 Hung Phu Street, District 8, Ho Chi Minh City, Vietnam.
| | - Ninh Hoang Le
- Institute of Public Health, 159 Hung Phu Street, District 8, Ho Chi Minh City, Vietnam.
| | - Vishnu Khanal
- School of Public Health, Curtin University, Bentley, Western Australia, Australia.
| | - Rachael Moorin
- School of Public Health, Curtin University, Bentley, Western Australia, Australia.
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Hayashi Y, Hai HH, Tai NA. Assessment of the needs of caregivers of stroke patients at state-owned acute-care hospitals in southern Vietnam, 2011. Prev Chronic Dis 2013; 10:E139. [PMID: 23968582 PMCID: PMC3754881 DOI: 10.5888/pcd10.130023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Care for stroke patients has improved steadily in southern Vietnam. Medical treatments such as thrombolytic therapy have been implemented at several hospitals, and stroke-care units composed of a team of various health professionals have been created. However, little attention has been focused on providing support to caregivers of stroke patients. This study aimed to characterize the caregivers of stroke patients who were treated in state-owned acute-care hospitals and to learn about their needs when patients are discharged. Such information can be used to enhance the caregiver's support system. METHODS We used questionnaires to conduct a descriptive study in 2011 at a state-owned acute-care hospital in southern Vietnam. We recruited study participants from among caregivers of stroke patients who had been informed of their hospital discharge date. We assessed 8 caregiver characteristics, and caregiver participants selected their needs from the survey's list of 15 possible needs. We analyzed the data by using the independent sample t test and logistic regression. RESULTS Of the 93 caregivers who consented to participate, 86 (92.5%) completed the survey and indicated their concerns at discharge. The most frequently cited need was information on how to prevent stroke recurrence (72, 83.7%), followed by which drugs are most effective in preventing a relapse (62, 72.1%), how long recovery would take (61, 70.9%), and availability of hospitals in the patient's hometown (60, 69.8%). A little over half of caregivers indicated financial concerns. A caregiver's need for information on diet for a stroke survivor increased with the caregiver's education level. CONCLUSIONS This study revealed several needs among caregivers of stroke survivors in southern Vietnam that are similar to those found by studies of caregivers of stroke survivors in high-income countries. Our findings suggest that comprehensive stroke care that includes caregiver education about healthful diets and prevention of stroke recurrence is needed at state-owned acute-care hospitals in southern Vietnam.
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Affiliation(s)
- Yumiko Hayashi
- Rehabilitation Department, Becamex International Hospital, Becamex Tower, 230 Binh Duong Avenue, Phu Hoa Ward, Thu Dau Mot City, Binh Duong Province, Vietnam.
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Son PT, Quang NN, Viet NL, Khai PG, Wall S, Weinehall L, Bonita R, Byass P. Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey. J Hum Hypertens 2011; 26:268-80. [PMID: 21368775 DOI: 10.1038/jhh.2011.18] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective of this study was to estimate mean blood pressure (BP), prevalence of hypertension (defined as BP ≥140/90 mm Hg) and its awareness, treatment and control in the Vietnamese adult population. This cross-sectional survey took place in eight Vietnamese provinces and cities. Multi-stage stratified sampling was used to select 9832 participants from the general population aged 25 years and over. Trained observers obtained two or three BP measurements from each person, using an automatic sphygmomanometer. Information on socio-geographical factors and anti-hypertensive medications was obtained using a standard questionnaire. The overall prevalence of hypertension was 25.1%, 28.3% in men and 23.1% in women. Among hypertensives, 48.4% were aware of their elevated BP, 29.6% had treatment and 10.7% achieved targeted BP control (<140/90 mm Hg). Among hypertensive aware, 61.1% had treatment, and among hypertensive treated, 36.3% had well control. Hypertension increased with age in both men and women. The hypertension was significantly higher in urban than in rural areas (32.7 vs 17.3%, P<0.001). Hypertension is a major and increasing public health problem in Vietnam. Prevalence among adults is high, whereas the proportions of hypertensives aware, treated and controlled were unacceptably low. These results imply an urgent need to develop national strategies to improve prevention and control of hypertension in Vietnam.
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Affiliation(s)
- P T Son
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
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