Background:In India the incidence of end stage renal disease (ESRD) is increasing day by day and the option for the treatment of ESRD is dialysis or transplantation. In the present scenario, due to the cost of treatment normal people can afford only hemodialysis rather than transplantation. Since the cost of hemodialysis differs across the country, research is needed to evaluate its exact cost.Aim:This study is to analyze the healthcare cost of hemodialysis in a private hospital of South India.Materials and Methods:This is a prospective, observational study carried out in a tertiary care hospital. Patients who are undergoing routine hemodialysis in this hospital were selected for the study. Patient data as well as cost details were collected for a period of six months. Thirty patients were selected for the study and a total of 2160 dialysis sessions were studied. Patient perspective was taken for the analysis of cost. Both direct and indirect costs were analyzed. This includes cost of dialysis, investigations, erythropoietin, food, transportation, lost wages etc. Socioeconomic status of the patient was also studied.Result:The total cost per session was found to be around Rs. 4500. Fifty six percent contributes direct medical cost whereas 20% contributes direct non medical cost. Twenty four percent cost was due to indirect costs. Since the patients are paying from their own pocket, only the upper or upper middle class patient can undergo hemodialysis regularly.Conclusion:These findings are important to find out the impact of cost of hemodialysis on patients suffering from ESRD. Further studies related to costs and outcome, otherwise known as pharmacoeconomic studies, are needed to analyze the pros and cons of renal replacement therapy and to improve the quality of life of ESRD patients. Thus pharmacoeconomical studies are needed to realize that government has to take initiative to provide insurance or reimbursement for the common people.
Our findings are in general agreement with those of previous research, and with our experiences of working with older adults in Pittsburgh and the Netherlands. This research will inform the development of an intervention to prevent depression in older adults in Goa.
INTRODUCTIONHealthy childhood is the basis for healthy and productive adult life. School is the place where apart from formal education, children also learn behavioral, lifestyle and moral values. Health is one of the key factors determining the enrollment, performance and continuation in school. 1School health services are considered to be an ideal platform to detect and address health problems in children at earliest. School health services in India dates back to 1909, when for the first time medical examination of school children was carried out in Baroda city. ABSTRACTBackground: Malnutrition and poor health among school children is the common cause of low school enrolment, high absenteeism, early dropout and poor classroom performance. This study was conducted to assess the various morbidities and nutritional status among school children. Methods: This descriptive study was conducted during year 2013 in a higher secondary school located in a coastal area of Puducherry. A total of 714 students were interviewed and examined. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Body weight and height were measured using standardized procedures. WHO criteria for classification of nutritional status was used. Visual acuity and colour vision was assessed using Snellen's chart and Ishihara's pseudo isochromatic chart respectively. Mean scores and proportions were calculated and chi-square test was applied. P value of <0.05 was considered as statistically significant. Results: Among 714 student, 369 (51.4%) were males and 345 (48.6%) were females. The mean age of children was 10.2 ± 3.1 years. Among all age groups and both sexes, the observed BMI was lower as compared to the reference values. The prevalence of underweight among children of 5-9 years was (30.7%) and (1.1%) were severely underweight. The prevalence of stunting was 10.4%, including 0.1% of severely stunted children. A total of 30.7% children were thin (low BMI for age). Pallor (39.5%), myopia (34.9%) and dental caries (14.7%) were the common morbidities observed among children. The pallor was observed more commonly among girls and this difference was statistically significant (p value <0.05). Conclusion: Under-nutrition is a prevalent condition among school children. Apart from various nutritional programmes, health education to parents, community and school teachers are quite important to address this problem.
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