Economic impact of surgery on households and individuals in low income countries: A systematic review

Platt, Esther; Doe, Matthew; Kim, Na Eun; Chirengendure, Bright; Musonda, Patrick; Kaja, Simba; Grimes, Caris

doi:10.1016/j.ijsu.2021.105956

Cited by 9 publications

(11 citation statements)

References 42 publications

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“…Twenty-six (52%) studies defined FRP as a concept,37–62 with 23 (46%) studies specifically referring to FRP as a necessary step to achieving UHC 37–46 49–51 53–62. Some studies suggested that FRP is achieved when households are able to use safe, effective and high-quality health services, without sacrificing other necessities for well-being, such as nutrition 37–39 45 49 51 53 54.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-eight studies (76%) used one or more of the following FRP measures: (1) out-of-pocket expenditures (OOPE) (n=31, 62%), (2) catastrophic health expenditures (CHE) (n=25, 50%) and (3) impoverishing health expenditures (IHE) (n=11, 22%), with 21 (42%) studies mentioning at least two measures, and eight (16%) considering all three. These measures may be calculated for all health-related expenditures or for specific categories of services, such as chronic disease, infectious disease or maternal health 44 48 52 55. As CHE and IHE are measured against thresholds, some studies may also calculate the mean positive overshoot of the threshold to quantify the intensity of financial hardship 44 45 61…”

Section: Resultsmentioning

confidence: 99%

“…OOPE include payments, not reimbursed by insurance, made by individuals or households to meet health-related needs 39 46 53 56 57 63 64. Direct payments include health service costs and indirect payments may include transportation costs and losses in productivity or income when accessing health services 39 48 52 55 57 63 64. OOPE indicators may be measured as changes in spending due to illness46 53 55 65; as the proportion of annual wages or disposable income43; or as a proportion of the ability to pay, defined as basic need expenditures (with food often used as a proxy for basic needs) 39 44 55 62.…”

Section: Resultsmentioning

confidence: 99%

“…Direct payments include health service costs and indirect payments may include transportation costs and losses in productivity or income when accessing health services 39 48 52 55 57 63 64. OOPE indicators may be measured as changes in spending due to illness46 53 55 65; as the proportion of annual wages or disposable income43; or as a proportion of the ability to pay, defined as basic need expenditures (with food often used as a proxy for basic needs) 39 44 55 62. The occurrence of OOPE may reflect a low degree of FRP because even small OOPE can cause financial hardship for poor households 39 56 66…”

Section: Resultsmentioning

confidence: 99%

“…39 One review recommended that costs should be consistently converted to US dollars to improve comparability. 55 Two reviews also noted a lack of validated disease-specific measures of financial risk, such as cancer-related financial toxicity, which limits comparability. 48 52 Data aggregation Meta-analyses could not be performed in many quantitative reviews.…”

Section: Quantitative Datamentioning

confidence: 99%

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Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews

et al. 2022

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ObjectivesFinancial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 universal health coverage (UHC) target. We sought to characterise what is known about FRP in the UHC context and to identify evidence gaps to prioritise in future research.DesignScoping overview of reviews using the Arksey & O’Malley and Levac & Colquhoun framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.Data sourcesMEDLINE, PsycINFO, CINAHL-Plus and PAIS Index were systematically searched for studies published between 1 January 1995 and 20 July 2021.Eligibility criteriaRecords were screened by two independent reviewers in duplicate using the following criteria: (1) literature review; (2) focus on UHC achievement through FRP; (3) English or French language; (4) published after 1995 and (5) peer-reviewed.Data extraction and synthesisTwo reviewers extracted data using a standard form and descriptive content analysis was performed to synthesise findings.Results50 studies were included. Most studies were systematic reviews focusing on low-income and middle-income countries. Study periods spanned 1990 and 2020. While FRP was recognised as a dimension of UHC, it was rarely defined as a concept. Out-of-pocket, catastrophic and impoverishing health expenditures were most commonly used to measure FRP. Pooling arrangements, expansion of insurance coverage and financial incentives were the main interventions for achieving FRP. Evidence gaps pertained to the effectiveness, cost-effectiveness and equity implications of efforts aimed at increasing FRP. Methodological gaps related to trade-offs between single-country and multicountry analyses; lack of process evaluations; inadequate mixed-methods evidence, disaggregated by relevant characteristics; lack of comparable and standardised measurement and short follow-up periods.ConclusionsThis scoping overview of reviews characterised what is known about FRP as a UHC dimension and found evidence gaps related to the effectiveness, cost-effectiveness and equity implications of FRP interventions. Theory-informed mixed-methods research using high-quality, longitudinal and disaggregated data is needed to address these objectives.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Quantitative Datamentioning

confidence: 99%

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Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews

et al. 2022

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Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

et al. 2023

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Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.

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Medical cost of environmental pollution: evidence from the Chinese Social Survey

Li,

Yan,

Zhang

2023

Environ Sci Pollut Res

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Economic impact of surgery on households and individuals in low income countries: A systematic review

Cited by 9 publications

References 42 publications

Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews

Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews

Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

Medical cost of environmental pollution: evidence from the Chinese Social Survey

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