Crowdfunding for medical expenses in the United Kingdom

Background

Medical crowdfunding is a rapidly growing phenomenon worldwide and a new means for patients to finance health related expenses. It raises many ethical concerns such as increasing inequities. In the UK, which operates a state-funded universal health care system, the phenomenon is unexpected and hasn't yet been studied. Our study aims at answering basic questions as who is using crowdfunding to fund health-related expenses, for what and why.

Methods

We have drawn the first 400 medical campaigns amongst 1,000 available on GoFundMe UK website. We used a content analysis method to extract data from narratives on age, sex, health condition and funds' purposes.

Results

Among the 400 campaigns, 1/2 requested funds for cancer care for both common and rare cancers, from which 1/3 disclosed a stage 4. A third of the sample sought funds to get treatment abroad, mostly in Germany and the US, for most part cancer therapies such as immunotherapy but also alternative therapies. A quarter of the sample sought support to alleviate financial burden associated with ill-health. Other purposes included getting private care in the UK (19%) and getting medical equipment (18%).

Conclusions

Our findings may put forward some gaps within the National Health Service (NHS) and social care such as issues to access therapies or equipment, lack of holistic care and inadequate welfare patient support. However, it does not explain fully the rise of crowdfunding that may also be a counterpart of patients' empowerment. For instance, patients can shift to the private sector, in the UK or abroad, when a treatment is not available within the NHS, such as high cost last-resort treatments for those with poor prognosis. We recommend policy makers to: use medical crowdfunding to inform policy,support patients to make empowered decisions,protect patients from commercial traps.

Key messages

Studying medical crowdfunding allows better understanding of patients’ perceived or actual unmet need for health and social care to inform policy development. This threat to equity should be addressed globally by providing patients with support to be empowered, with universal health coverage and by regulating better private facilities and health tourism.

Patterns of beverage purchases amongst British households: a latent class analysis

Background

Policies to tackle obesity have increasingly targeted drinks, in particular sugar-sweetened beverages (SSBs), as a major source of excess sugar and energy. However, precision targeting of policies is difficult as information on what types of consumers they might affect, and to what degree, is missing. To fill this gap, we categorised consumers on the basis of drink purchase behaviour and explored whether they are patterned by socio-demographic characteristics, total food purchasing and weight status.

Methods

We used latent class (LC) analysis to characterise patterns of drink purchases using the 2016 UK Kantar FMCG household purchase panel. We restricted analyses to frequent purchasers of drinks (n = 8,675) and used 6 drink categories: SSB; diet drink; fruit-/milk-based drinks; beer & cider; wine; and water. We used multinomial logistic and linear models to relate household characteristics, BMI and food purchase behaviours to LC membership.

Results

We identified 7 LCs. Disadvantaged households were more frequent in LCs with high volumes of SSBs ('SSB') and diet drinks ('Diet'). Higher BMI was more likely in LCs 'Diet' and 'SSB'. LC 'SSB' obtained higher total energy, relatively less energy from fruits and vegetables, and more energy from less healthy products, compared to others. LCs 'Diet' and 'SSB' obtained relatively more energy from sweet snacks.

Conclusions

Households who mainly purchased high volumes of SSBs or diet drinks were at greater risk of obesity and tended to purchase less healthy foods, including a high proportion of energy from sweet snacks. These households might additionally benefit from policies targeting unhealthy foods, such as sweet snacks, as a way of reducing excess energy intake.

Key messages

The effects of fiscal policies on SSB consumption is likely to vary across types of beverage consumers. Fiscal policies should be extended to sweet snacks as a major source of excess energy.

A review of the metrics for One Health benefits

One Health as a concept has been with us for many years, yet it is only recently that it is actively being discussed as a way of mitigating risks in society. Initiatives in the use of this concept require methods to monitor the benefits gained from an holistic approach to health, yet there is an absence of adequate frameworks to measure One Health benefits. This paper explores the problem with a review of the available literature and an examination of methods used. It concludes that most published work on One Health describes how this concept is valuable without trying to estimate the size of benefit or type of value. A framework for measuring the advantages of a One Health approach is needed and, through the process of an international workshop and the development of a One Health business case, the authors are working towards its development.