Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries

Arsenijevic, Jelena; Pavlova, Milena; Rechel, Bernd; Groot, Wim

doi:10.1371/journal.pone.0157765

Cited by 73 publications

(76 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Apart from the income‐related and region‐related disparity in financial protection were shown previous studies, the growing prevalence of chronic disease also contributed to high out‐of‐pocket payments (OOP) for health services and drugs. Evidence from South Korean and 15 European countries concluded that households with members suffering from chronic diseases are more likely to experience CHE than general households, even in some of the developed countries worldwide . In general, the changes over the last decade of socio‐economic disparity in financial protection in China at national level are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Zhao

Oldenburg

Mahal

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

objectives To investigate trends and socio-economic disparities in the catastrophic health expenditure (CHE) and health impoverishment in China after major reform of the health system and to examine the impacts of the chronic disease on CHE and impoverishment.methods We obtained data from four rounds of the China Family Panel Studies 2010-2016, with a sample size of 14 960 households. We defined CHE as the point at which annual household health payments exceeded 40% of annual capacity to pay. Impoverishment is measured by the $1.90 per day poverty line. Multivariate logistic regression models were performed to identify impacts of the family member with chronic disease on CHE and impoverishment.results Between 2010 and 2016, the incidence of CHE in China decreased from 19.37% to 15.11% and from 7.39% to 5.14% for health impoverishment; however, the decrease in level of impoverishment was less in rural areas (from 6.16% down to 3.03%) than in urban areas (from 8.46% down to 7.81%). The gap between impoverishment rates across the income quartiles is growing. Multivariable analysis showed that households with two or more members suffering chronic diseases were significantly more likely to incur CHE (aOR: 2.46, 95% CI: 1.93-3.13) and impoverishment (aOR: 2.66, 95% CI: 1.87-3.78) than households with no members suffering chronic diseases, after adjusting for sociodemographic covariates.conclusions Important advances have been made in achieving greater financial protection for Chinese citizens. Nevertheless, greater attention to the poor households with chronic disease members is needed. Policymakers in China should focus on optimising integrated rural-urban health insurance by expanding the current benefit packages and strengthening poverty alleviation efforts.keywords catastrophic health expenditure, health impoverishment, socio-economic disparity, China Sustainable Development Goals (SDGs): SDG 1 (no poverty), SDG 3 (good health and well-being), SDG 8 (decent work and economic growth), SDG 10 (reduced inequalities), SDG 11 (sustainable cities and communities), SDG 17 (partnerships for the goals)

show abstract

Section: Introductionmentioning

confidence: 99%

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Zhao

Oldenburg

Mahal

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…These rates were higher than those of developed countries,but were lower than those of low-income countries. 29,30 The incidences of CHE participating in medical insurance were 3.6% higher than those of uninsured households (16.3%). In addition, families with cardiovascular disease have a much higher risk of IME than families without cardiovascular disease (7.0%) and the overall population (7.2%).It can be seen that cardiovascular disease patients' risk tolerance for health care payments is actually lower than the average in China.…”

Section: Discussionmentioning

confidence: 93%

Does the Medical Insurance System Play a Real Role in Reducing Catastrophic Economic Burden in Elderly Patients with Cardiovascular Disease in China? Implication for Accurately Targeting Vulnerable Characteristics.

Wang

et al. 2019

Preprint

View full text Add to dashboard Cite

Background:The vulnerability of cardiovascular disease (CVD) patients' health abilities, combined with the severity of the disease and the overlapping risk factors, can cause such people to bear the economic burden of the disease due to the use of medical services.We estimated the economic burden of patients with CVD and identified the weak link in the design of the medical insurance. Methods:Data from 5,610 middle-aged and elderly with CVD were drawn from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). The recommended method of the World Health Organization (WHO) was adopted to calculate catastrophic health expenditure (CHE), impoverishment by medical expenses (IME), and applied the treatment-effect model to analyze the determinants of CHE. Results:The incidence of CHE was 19.9% of the CVD, compared to 7.6% of the sample households trapped in IME. The incidence of CHE in CVD participating in medical insurance was 2.6% higher than for uninsured families (16.3%).Family size, health satisfaction,combine with other chronic diseases, having hospitalization and disabled members, and participating in insurance were found to be significantly associated with the likelihood of CHE. Conclusions:Elderly with physical vulnerabilities were more prone to CHE. The medical insurance only reduced barriers to accessing health resources for elderly with CVD, but lacked policy inclination for high-utilization populations,and had poorly accurate identification of vulnerable characteristics of CVD,which in turn affects the economic protection ability of the medical insurance. The dispersion between the multiple medical security systems leads to the existence of blind spots in the economic risk protection of individuals and families. Keywords:cardiovascular disease, catastrophic health expenditure, impoverishment by medical expense, medical insurance, elderly households Background Aging, rapid urbanization, and shifting disease patterns are causing cardiovascular disease (CVD) to become established as one of the primary diseases in the world. 1.2 Worldwide, roughly 17.9 million people die of CVD each year, and the absolute number of deaths from chronic CVD worldwide increased by 42. 4% between 1990-2015 ( 2017). 3,4 The incidence and mortality of CVD are also serious in China. As of 2015, there were 290 million people suffering from CVD in China, including Out-of-pocket health expenditure :OOP Household consumption expenditure:EXP Instrumental Variable :IV Declarations Ethics approval and consent to participateNot applicable Consent for publicationNot applicable Availability of data and materialsDataset available from the CHARLS repository,

show abstract

“…Cardiovascular diseases costs are very high, so that in the European Union (EU) in 2016, the direct and indirect costs (premature death and disability) of CVDs were estimated to be about 25 and 18 billion euros, respectively (3,8). It has also increased the inequality in health care nancing by increasing OOP expenditure and catastrophic health expenditures (9). In the US, direct and indirect cost of CVDs was totally about 329.9 billion USD, and it is estimated to increase to 1.1 trillion USD in 2035 (10).…”

Section: Introductionmentioning

confidence: 99%

Economic Burden of Cardiovascular Diseases Before and After the Iran’s Health Transformation Plan: A Cross-Sectional Study on Referral Hospital in the North-West of Iran

Alipour

Zandian

Yazdi‐Feyzabadi

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundDifferent countries have set different policies to control and decrease the costs of Cardiovascular Diseases(CVDs). Iran aiming reducing the economic burden of different disease by a recent reform from named as health transformation plan(HTP). This study aimed to examine economic burden of CVDs before and after of HTP, MethodsThis cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran's Ministry of Cooperatives, Labor, and Social Welfare, central bank of the Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials(IRR). ResultsTotal costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after(62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p=0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2% to 36.7%. All hospitalization costs, except patients' OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. ConclusionThe economic burden of CVDs after the HTP increased in the north-west of Iran due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to

show abstract

Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries

Cited by 73 publications

References 47 publications

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Does the Medical Insurance System Play a Real Role in Reducing Catastrophic Economic Burden in Elderly Patients with Cardiovascular Disease in China? Implication for Accurately Targeting Vulnerable Characteristics.

Economic Burden of Cardiovascular Diseases Before and After the Iran’s Health Transformation Plan: A Cross-Sectional Study on Referral Hospital in the North-West of Iran

Contact Info

Product

Resources

About