Health, wealth, and medical expenditures among the elderly in rural Tanzania: experiences from Nzega and Igunga districts

BACKGROUND

The per capita health expenditure (HE) and share of gross domestic product (GDP) spending on elderly healthcare are expected to increase. The gap between health needs and available resources for elderly healthcare is widening in many developing countries, like Tanzania, leaving the elderly in poor health. These conditions lead to catastrophic HEs for the elderly. This study aimed to analyse the association between measures of health, wealth, and medical expenditure in rural residents aged 60 years and above in Tanzania.

METHODS

The data of this study were collected through a cross-sectional household survey to residents aged 60 years and above living in Nzega and Igunga districts using a standardised World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) and European Quality of Life Five Dimension (EQ-5D) questionnaires. The quality of life (QoL) was estimated using EQ-5D weights. The wealth index was generated from principal component analysis (PCA). The linear regression analyses (outpatient/inpatient) were performed to analyse the association between measures of health, wealth, medical expenditure, and socio-demographic variables.

RESULTS

This study found a negative and statistically significant association between QoL and HE, whereby HE increases with the decrease of QoL. We could not find any significant relationship between HE and social gradients. In addition, age influences HE such that as age increases, the HE for both outpatient and inpatient care also increases.

CONCLUSION

The health system in these districts allocate resources mainly according to needs, and social position is not important. We thus conclude that the elderly of lower socio-economic status (SES) was subjected to similar health expenditure as those of higher socio-economic status. Health, not wealth, determines the use of medical expenditures.

Financial situation and challenges for management of SME hospitals: Evidence from Poland

The hospital represents a specific organisation, operating in a turbulent environment and financed to a large extent by public funds. The health sector is exposed to constant political and social pressure. This causes significant problems with maintaining its financial stability, which particularly affects hospitals in the SME sector. The aim of this paper is to examine the relationship between selected financial indicators and some environmental phenomena that affect the financial situation and future financial stability of a selected group of hospitals from the SME group. The results will also be compared to the situation of other SME entities. The research is based on descriptive analysis, descriptive statistics, and correlation analysis of selected data. The results indicate that the financial situation of hospitals belonging to the SME group differs significantly from the overall SME sector, and does not bode positively for their future development. The current financial situation presents particular challenges for managers in balancing financial streams and ensuring economic sustainability. At the same time, this situation should encourage decision-makers to ensure an adequate level of revenues for these public service providers, as well as face other challenges related to operational management.

The Correlation between Social Support and Quality of Life of Seniors without Cognitive Disorders from an Institutional Environment-A Descriptive Cross-Sectional Survey

The aim of this study was to confirm the correlation between social support and the quality of life of seniors who live without cognitive disorders, but are living in an institutional environment. The measurement of variables was based on a cross-sectional survey method. A representative sample of 957 seniors participated in the survey. The study covered public nursing homes (NHs) and residential care homes (RCHs) selected for the study by stratified sampling. The results confirmed a linear correlation between social support and the quality of life of seniors (p < 0.001). It was also confirmed that there were differences in the range of studied variables depending on the type of institution (NH versus RCH; p < 0.001). Social support is a significant component, and at the same time, a modifier of the perception of the quality of life for older people. Its variable level determines the subjective assessment of functioning in particular domains of quality of life. RCH as an institution of a social nature satisfies the needs for support at a higher level than NH, which translates into a better perception of older people’s quality of life.