Estimation and determinants of direct medical costs of ischaemic heart disease, stroke and hypertensive heart disease: evidence from two major hospitals in Cameroon

Abstract

Background Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking. Methods A prevalence-based cost-of-illness study was conducted from a healthcare provider perspective and enrolled patients with ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke and hypertensive heart disease (HHD) from two major hospitals between 2013 and 2017. Determinants of cost were explored using multivariate generalized linear models. Results Overall, data from 850 patients: IHD (n = 92, 10.8%), ischaemic stroke (n = 317, 37.3%), haemorrhagic stroke (n = 193, 22.7%) and HHD (n = 248, 29.2%) were analysed. The total cost for these CVDs was XAF 676,694,000 (~US$ 1,224,918). The average annual direct medical costs of care per patient were XAF 1,395,200 (US$ 2400) for IHD, XAF 932,700 (US$ 1600) for ischaemic stroke, XAF 815,400 (US$ 1400) for haemorrhagic stroke, and XAF 384,300 (US$ 700) for HHD. In the fully adjusted models, apart from history of CVD event (β = − 0.429; 95% confidence interval − 0.705, − 0.153) that predicted lower costs in patients with IHD, having of diabetes mellitus predicted higher costs in patients with IHD (β = 0.435; 0.098, 0.772), ischaemic stroke (β = 0.188; 0.052, 0.324) and HHD (β = 0.229; 0.080, 0.378). Conclusions This study reveals substantial economic burden due to CVD in Cameroon. Diabetes mellitus was a consistent driver of elevated costs across the CVDs. There is urgent need to invest in cost-effective primary prevention strategies in order to reduce the incidence of CVD and consequent economic burden on a health system already laden with the impact of communicable diseases.

Estimation and predictors of direct hospitalisation expenses and in-hospital mortality for patients who had a stroke in a low-middle income country: evidence from a nationwide cross-sectional study in Iranian hospitals

“…These findings are consistent with similar, relevant studies. 16 25 27 Patients suffering from HS have a longer average other ward LoS compared with other ward patients who had a I&US (12.33±14.48 days) and significantly longer ICU LoS (6.68±12.44 days). In addition, patients who had an HS undergo more brain surgery than patients who had a IS, adding to their expenses, which may partly explain some differences.…”

“…In addition, the log link function has the advantage of ensuring non-negative results by preserving the original scale of the data, as opposed to log transformation. 16 24 …”

Análise econômica em saúde: O que precisamos saber?

“…Com isso, as avaliações econômicas entram com descobertas importantes para os formuladores de políticas de saúde, as quais fornecem evidências do fardo econômico contemporâneo e informam o estabelecimento de prioridades de recursos. Portanto, investir em estratégias de prevenção é desejar reduzir o ônus econômico sobre sistema de saúde já sobrecarregado (Aminde et al, 2021). Nesse processo para tomada de decisão, o gestor utiliza conhecimentos, técnicas e procedimentos que lhe permitem conduzir o funcionamento dos serviços na direção dos objetivos definidos (Tanaka & Tamaki, 2012).…”

“…Ponderam, também, sobre os custos dos recursos aplicados e das consequências obtidas em termos de saúde, a fim de apoiar decisões de quais serviços devem ser financiados e quais não deveriam, procurando sempre maximizar os benefícios com o orçamento disponível. A avaliação econômica é construída sobre a noção de escassez, logo, os recursos são cada vez mais limitados e a tomada de decisão deve ser sempre pelo melhor uso dos recursos; em vista disso, a avaliação econômica fornece informações para que a tomada de decisão seja mais racional (Byford et al, 2003), a qual estrutura os serviços em saúde (Aminde et al, 2021). Desse modo, atualmente os gastos públicos variam tão amplamente entre as nações, sendo menos de 20% dos custos totais de saúde em países de alta renda e, por outro lado, até 66% em países de baixa renda (Organização Mundial da Saúde [OMS], 2021).…”

Impact of High-Pressure Processing on Antioxidant Activity during Storage of Fruits and Fruit Products: A Review

“…Some authors have proposed intervention programs to promote fruit and vegetable consumption [ 4 , 5 , 6 ] considering the association of their low consumption with some diseases, pointed out from the beginning of 2000s [ 7 , 8 ]. Most of them are called non-communicable diseases by WHO [ 9 ]: cancers [ 10 , 11 , 12 ], obesity [ 13 ], high blood pressure [ 14 ] and other cardiovascular illnesses [ 15 ], strokes [ 16 ], osteoporosis [ 17 ], osteoarthritis [ 18 ], type 2 diabetes [ 19 ], degenerative diseases [ 20 ], among others. They are known to reduce the risk of cancer, heart disease, and diabetes; to inhibit plasma platelet aggregation, cyclooxygenase activity, and histamine release, as well as to exert antibacterial, antiviral, anti-inflammatory, and anti-allergenic activities [ 21 ].…”