BackgroundDengue is associated with significant economic expenditure and it is estimated that the Asia Pacific region accounts for >50% of the global cost. Indonesia has one of the world’s highest dengue burdens; Aedes aegypti and Aedes albopictus are the primary and secondary vectors. In the absence of local data on disease cost, this study estimated the annual economic burden during 2015 of both hospitalized and ambulatory dengue cases in Indonesia.MethodsTotal 2015 dengue costs were calculated using both prospective and retrospective methods using data from public and private hospitals and health centres in three provinces: Yogyakarta, Bali and Jakarta. Direct costs were extracted from billing systems and claims; a patient survey captured indirect and out-of-pocket costs at discharge and 2 weeks later. Adjustments across sites based on similar clinical practices and healthcare landscapes were performed to fill gaps in cost estimates. The national burden of dengue was extrapolated from provincial data using data from the three sites and applying an empirically-derived epidemiological expansion factor.ResultsTotal direct and indirect costs per dengue case assessed at Yogyakarta, Bali and Jakarta were US$791, US$1,241 and US$1,250, respectively. Total 2015 economic burden of dengue in Indonesia was estimated at US$381.15 million which comprised US$355.2 million for hospitalized and US$26.2 million for ambulatory care cases.ConclusionDengue imposes a substantial economic burden for Indonesian public payers and society. Complemented with an appropriate weighting method and by accounting for local specificities and practices, these data may support national level public health decision making for prevention/control of dengue in public health priority lists.
Background: Rational drug use (RDU) generally covers appropriate prescribing, appropriate dispensing and appropriate patient use of medicines for the diagnosis, prevention, mitigation and treatment of diseases. To enhance RDU, the patient should receive medicines appropriate to their heath care conditions, at optimum doses and sufficient time, as well as at the cost that the individual and the community can afford. This study aimed to review systematically the rational drug use to increase service quality in developing countries. Subjects and Method: A systematic review was conducted by searching the following databases included PubMed, Proquest and Garuda which published articles in last ten years. The keywords for this review included rational drug use, irrational drug use, drug use pattern, WHO indicator, hospital, developing country, and cross sectional. The inclusion criteria were review, systematic review, clinical review and guidelines. After review process 13 articles were included in this review. Results: The average prescription was varying in several development countries included India, Ethiopia, Jordan, Pakistan, Indonesia, and Sri Lanka. The highest average prescription generic drug was in Ethiopia (90.61%) and lowest was in India (25.37%). The average prescription antibiotics highest was in Ethiopia (58.1%) and lowest was in Indonesia (36%). The percentage of injection prescriptions that exceed WHO recommendations occurs in Ethiopia (38.1%). Percentage of compliance with the List of Essential Medicines highest was in India (74.3%), and Sri Lanka (100%). Prescriptions were adequately labeled highest was in Pakistan (100%) otherwise lowest was in Ethiopia (45.4%). Patients know about the dosage of the prescription highest was in Ethiopia (78.8%) and Pakistan (61.6%). All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline. Conclusion: Rational drug use in several countries is slightly above the WHO recommendation. An intervention strategy includes managerial, educational, regulatory and economical strategies should be designed to solve the problem on the health care system in general.
Stroke to this day is still a disease that causes a high disability. In the future, it will require a prohibitive cost so that it has an impact on the socio-economic consequences for patients and their families. The price is prohibitive so that the impact on socioeconomic implications for patients and their families. Because of that, the purpose of the study is to estimate the cause of the cost that causes an economic burden from a stroke. The method that is used is a content analysis by doing a further literature review from various sources, from journal to textbook from a national level to international. Literature studies show that direct medical cost, which is rehabilitation, and nursing care cost is identified as the leading contributor to the high price of economic burden from a stroke. High costs incurred cause family to experience catastrophic financial disaster; it even impacts to drop welfare level. Social preventive action is needed to reduce the high prevalence of stroke to reduce the cost, to protect every household from financial disaster from a stroke.
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