Disease Control Priorities, Third Edition (Volume 5): Cardiovascular, Respiratory, and Related Disorders

Prabhakaran, Dorairaj; Anand, Shuchi; Gaziano, Thomas A.; Mbanya, Jean-Claude; Wu, Yangfeng; Nugent, Rachel

doi:10.1596/978-1-4648-0518-9

Cited by 30 publications

(27 citation statements)

References 567 publications

(770 reference statements)

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“…To the best of our knowledge, there have been no previous costing studies on RHD in Africa and, only one prior costing study in a low-and middle-income country setting. Terreri et al, looking at RHD in Brazil, quanti ed per-patient direct costs of RHD and rheumatic fever from the provider perspective using the ingredients approach [1]. Even after adjusting to a common currency and year, the cost estimates in this study are higher than in the Brazilian study, probably due to advances in care (i.e.…”

Section: Discussionmentioning

confidence: 57%

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Health System Costs of Rheumatic Heart Disease Care in South Africa

Hellebo

Zühlke

Watkins

et al. 2020

Preprint

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BackgroundRheumatic Heart Disease (RHD) is a disease of poverty that is neglected in developing countries, including South Africa. Lack of adequate evidence regarding the cost of RHD care has hindered national and international actions to prevent RHD related deaths. The objective of this study was to estimate the cost of RHD-related health services in a tertiary hospital in the Western Cape, South Africa. MethodsThe primary data on service utilization were collected from a randomly selected sample of 100 patient medical records from the Global Rheumatic Heart Disease Registry (the REMEDY study), a registry of individuals living with RHD. Patient-level clinical data, including, prices and quantities of medications and laboratory tests, were collected from the main tertiary hospital providing RHD care. All annual costs from health system perspective were estimated in 2017 (base year) South African Rand (ZAR) using a combination of ingredients and step-down costing approaches and later converted to United States dollars (US$). Step-down costing was used to estimate provider time costs and all other facility costs such as overheads. 3% discount rate was also employed in order to allow depreciation and opportunity cost. We aggregated data to estimate the total annual costs and the average annual per-patient cost of RHD and conducted a one-way sensitivity analysis. ResultsThe estimated total cost of RHD care at the tertiary hospital was US$ 2 million (in 2017 US$) for the year 2017, with surgery costs accounting for 65%. Per-patient average annual costs were US$ 3900. For the subset of costs estimated using the ingredients approach, outpatient medications, and consumables related to cardiac catheterization and heart valve surgery were the main cost drivers. ConclusionsRHD-related healthcare consumes significant tertiary hospital resources in South Africa, with annual per-patient costs higher than many other non-communicable and infectious diseases. This analysis supports the scaling up of primary and secondary prevention programs at primary health centers in order to reduce future tertiary care costs. The study could also inform resource allocation efforts and provide cost estimates for future studies of intervention cost-effectiveness.

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Section: Discussionmentioning

confidence: 57%

“…Rheumatic heart disease (RHD) is the most common acquired cardiovascular disease among children and adolescents in low-and middle-income countries [1,2]. It is a chronic in ammatory disease of the heart valves that result from recurrent episodes of acute rheumatic fever (ARF).…”

Section: Introductionmentioning

confidence: 99%

Health System Costs of Rheumatic Heart Disease Care in South Africa

Hellebo

Zühlke

Watkins

et al. 2020

Preprint

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“… 1 Controlling blood pressure (BP) through daily, low-cost, medications substantially reduces the negative consequences of hypertension and is one of the most cost-effective ways of reducing mortality. 2–4 BP control is especially pressing in urban India, since over 30% of adults over the age of 30 are hypertensive and this prevalence is expected to increase substantially as the population ages. 5–7 Indeed, recent observational studies have found that improving BP control has the potential to result in large population-wide improvements in mortality in urban India and similar contexts.…”

Section: Introductionmentioning

confidence: 99%

Hypertension knowledge and treatment initiation, adherence, and discontinuation among adults in Chennai, India: a cross-sectional study

2021

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IntroductionA substantial share of urban Indians with diagnosed hypertension do not take regular treatment, potentially due to poor knowledge of hypertension consequences and treatment options. We describe hypertension knowledge and beliefs, treatment patterns, and reported reasons for treatment non-use among adults with diagnosed hypertension in Chennai, India.MethodsWe collected data on 833 adults ages 30+ with physician diagnosed hypertension using a door-to-door household survey within randomly selected wards of Chennai. We described the proportion of individuals who were not taking daily medications and their reported reasons for not doing so. Next, we described individuals’ knowledge of hypertension consequences and how to control blood pressure (BP) and assessed the association between knowledge and daily treatment use.ResultsOver one quarter (28% (95% CI 25% to 31%)) of diagnosed individuals reported not taking daily treatment. The largest proportion (18% (95% CI 16% to 21%)) were individuals who had discontinued prior treatment use. The primary reason individuals reported for non-daily use was that their BP had returned to normal. Just 23% (95% CI 20% to 26%) of individuals listed BP medications as the most effective way to reduce BP; however, these individuals were 11% points (95% CI 4% to 19%) more likely to take daily medications. Conversely, 43% (95% CI 40% to 47%) of individuals believed that BP medications should be stopped from time to time and these individuals were 15% points (95% CI −0.21 to –0.09) less likely to take daily treatment. While awareness of the consequences of hypertension was poor, we found no evidence that it was associated with taking daily medications.ConclusionsThere were large gaps in consistency of BP medication use which were strongly associated with knowledge about BP medications. Further research is needed to identify whether addressing beliefs can improve daily treatment use among individuals with diagnosed hypertension.

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“…2,4 Behavioral risk factors for NCDs, especially suboptimal diet, are prevalent as lifestyle changes because of the rapid economic growth in China. 1,8 As the dietary pattern among the Chinese has been dramatically westernized in the past two decades, the consumption of sugar-sweetened beverages (SSBs) increased steadily. [9][10][11][12] According to a national cross-sectional survey among 1584 adults aged 18 to 55 years in urban China in 2016, about half of them consumed more than one serving of SSBs per day.…”

Section: Introductionmentioning

confidence: 99%

The burden of ischemic heart disease and type 2 diabetes mellitus attributable to diet high in sugar‐sweetened beverages in China: An analysis for the Global Burden of Disease Study 2017

Li²,

Zhao

et al. 2020

Journal of Diabetes

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Background: The aim of this study was to estimate the burden of ischemic heart disease (IHD) and type 2 diabetes mellitus (T2DM) attributable to a diet high in sugar-sweetened beverages (SSBs) in China from 1990 to 2017.Methods: Data from the Global Burden of Disease Study 2017 were used to assess all-age and age-standardized, risk-attributable mortality, years of life lost (YLL), years of life with disability (YLD), and disability-adjusted life years (DALYs) by age, sex, year, province, and sociodemographic index (SDI).Results: For total noncommunicable diseases (NCDs), 12 523 (95% uncertainty interval 776-27 631) deaths, 305 288 (18 611-661 847) YLL, 142 051 (64 530-257 468) YLD, and 447 339 (132 677-858 838) DALYs were attributable to diet high in SSBs in 2017, particularly among males. Age-standardized, riskattributable mortality, YLL, YLD, and DALY rates increased distinctly by 507.3%, 410.3%, 571.0%, and 453.3% from 1990 to 2017 respectively. Age-sexspecific, risk-attributable mortality and YLL rates for IHD in older adults (over 65 years) were higher than in young (between 25 and 39 years) and middleaged adults (between 40 and 64 years) in 2017; however, the YLD and DALY rates for T2DM were higher in young and middle-aged males than in older males. The age-standardized, risk-attributable DALY rates for total NCDs increased substantially in high-SDI and high-middle-SDI provinces during the period.Conclusions: China has a huge and growing burden of IHD and T2DM attributable to diet high in SSBs, particularly among young and middle-aged male adults in wealthier provinces. Evidence-based public health policies at the provincial levels to reduce the consumption of SSBs should be prioritized in China.

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Disease Control Priorities, Third Edition (Volume 5): Cardiovascular, Respiratory, and Related Disorders

Cited by 30 publications

References 567 publications

Health System Costs of Rheumatic Heart Disease Care in South Africa

Health System Costs of Rheumatic Heart Disease Care in South Africa

Hypertension knowledge and treatment initiation, adherence, and discontinuation among adults in Chennai, India: a cross-sectional study

The burden of ischemic heart disease and type 2 diabetes mellitus attributable to diet high in sugar‐sweetened beverages in China: An analysis for the Global Burden of Disease Study 2017

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