Economic burden of chronic conditions among households in Myanmar: the case of angina and asthma

Htet, Soe; Alam, Khurshid; Mahal, Ajay

doi:10.1093/heapol/czu125

Cited by 19 publications

(20 citation statements)

References 19 publications

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“…Recent studies have compared PSM and coarsened exact matching, a newer method that uses stratification followed by exact matching of cohorts for key variables influencing study endpoints with strata-based weighting according to the proportion of patients in each stratum 12,31–33. The matching methods produced similar results in these studies; however, Wells et al12 reported that coarsened exact matching retained more patients and achieved better balance between cohorts than PSM.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

Burden¹,

Roche

Miglio³

et al. 2017

POR

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BackgroundCohort matching and regression modeling are used in observational studies to control for confounding factors when estimating treatment effects. Our objective was to evaluate exact matching and propensity score methods by applying them in a 1-year pre–post historical database study to investigate asthma-related outcomes by treatment.MethodsWe drew on longitudinal medical record data in the PHARMO database for asthma patients prescribed the treatments to be compared (ciclesonide and fine-particle inhaled corticosteroid [ICS]). Propensity score methods that we evaluated were propensity score matching (PSM) using two different algorithms, the inverse probability of treatment weighting (IPTW), covariate adjustment using the propensity score, and propensity score stratification. We defined balance, using standardized differences, as differences of <10% between cohorts.ResultsOf 4064 eligible patients, 1382 (34%) were prescribed ciclesonide and 2682 (66%) fine-particle ICS. The IPTW and propensity score-based methods retained more patients (96%–100%) than exact matching (90%); exact matching selected less severe patients. Standardized differences were >10% for four variables in the exact-matched dataset and <10% for both PSM algorithms and the weighted pseudo-dataset used in the IPTW method. With all methods, ciclesonide was associated with better 1-year asthma-related outcomes, at one-third the prescribed dose, than fine-particle ICS; results varied slightly by method, but direction and statistical significance remained the same.ConclusionWe found that each method has its particular strengths, and we recommend at least two methods be applied for each matched cohort study to evaluate the robustness of the findings. Balance diagnostics should be applied with all methods to check the balance of confounders between treatment cohorts. If exact matching is used, the calculation of a propensity score could be useful to identify variables that require balancing, thereby informing the choice of matching criteria together with clinical considerations.

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Section: Discussionmentioning

confidence: 99%

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

Burden¹,

Roche

Miglio³

et al. 2017

POR

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“…Nevertheless, the sample was projected from 2008 to 2012, applying the weights of situations of dependence by level and autonomous community, and considering the 2012 population data. Hence, the results should not be greatly affected by this lag in the data sources, since the evolution in the prevalence of disability tends to remain unchanged over time [48]. For instance, in Spain the prevalence of disability amounted to 6.2% in 1999 and 6.5% in 2008, while that of long term care increased only from 4.4% to 5.1% in the same time period [96].…”

Section: Discussionmentioning

confidence: 99%

“…However, those analyzing the effects of OPP payments or health insurance on LTC are more limited in number although interest in this issue is growing. Some studies have analyzed OOP payments for specific components of health care such as the chronically ill [47,48] and the disabled population [49][50][51]. In addition, a study across the OECD has measured the protection of long-term care and differences between countries.…”

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confidence: 99%

Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment

Rubio

García

Sotos

2020

IJERPH

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Background: Out-of-pocket (OOP) payments are configured as an important source of financing long-term care (LTC). However, very few studies have analyzed the risk of impoverishment and catastrophic effects of OOP in LTC. To estimate the contribution of users to the financing of LTC and to analyze the economic consequences for households in terms of impoverishment and catastrophism after financial crisis in Spain. Methods: The database that was used is the 2008 Spanish Disability and Dependency Survey, projected to 2012. We analyze the OOP payments effect associated to the impoverishment of households comparing volume and financial situation before and after OOP payment. At the same time, the extent to which OOP payment had led to catastrophism was analyzed using different thresholds. Results: The results show that contribution of dependent people to the financing of the services they receive exceeds by 50% the costs of these services. This expenditure entails an increase in the number of households that live below the poverty. In terms of catastrophism, more than 80% of households dedicate more than 10% of their income to dependency OOP payments. In annual terms, the catastrophe gap generated by devoting more than 10% of the household income to dependent care OOP payment reached €3955, 1 million (0.38% of GDP). Conclusion: This article informs about consequences of OOP in LCT and supplements previous research that focus on health. Our results should serve to develop strategic for protection against the financial risk resulting from facing the costs of a situation of dependence.

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“…However, those analyzing the effects of OPP payments or health insurance on LTC are more limited in number although interest in this issue is growing. Some studies have analyzed OOP payments for specific components of health care such as the chronically ill [34,35] and the disabled population [36][37][38]. In addition, a study across the OECD has measured the protection of long-term care and differences between countries.…”

Section: Documented In the Case Of Private Health Insurance Systemsmentioning

confidence: 99%

Financial catastrophism inherent with out-of-pocket payments in long term care for households: a latent impoverishment

Rubio

García

Sotos

2019

Preprint

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Background Out-of-pocket (OOP) payments are configured as an important source of financing long-term care (LTC). However, very few studies have analyzed the risk of impoverishment and catastrophic effects of OOP in LTC. Objective To estimate the contribution of users to the financing of LTC and to analyze the economic consequences for households in terms of impoverishment and catastrophism. Data and Methods The data base which was used is 2008 Spanish Disability and Dependency Survey, projected to 2012. We analyze the OOP payments effect associated to the impoverishment of households comparing volume and financial situation before and after OOP payment. At the same time, the extent to which OOP payment had led to catastrophism was analyzed using different thresholds. Results The results show that contribution of dependent people to the financing of the services they receive exceeds by 50% the costs of these services. This expenditure entails an increase in the number of households that live below the poverty. In terms of catastrophism, more than 80% of households dedicate more than 10% of their income to dependency OOP payments. In annual terms, the catastrophe gap generated by devoting more than 10% of the household income to dependent care OOP payment reached €3,955, 1 million (0,38% of GDP). Conclusion This article informs about consequences of OOP in LCT and supplements previous research that focus on health. Our results should serve to develop strategic for protection against the financial risk resulting from facing the costs of a situation of dependence.

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Economic burden of chronic conditions among households in Myanmar: the case of angina and asthma

Cited by 19 publications

References 19 publications

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment

Financial catastrophism inherent with out-of-pocket payments in long term care for households: a latent impoverishment

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