Health expenditure and catastrophic spending among older adults living with HIV

Negin, Joel; Randell, Madeleine; Raban, Magdalena Z.; Nyirenda, Makandwe; Kalula, Sebastiana; Madurai, Lorna; Kowal, Paul

doi:10.1080/17441692.2016.1173717

Cited by 19 publications

(15 citation statements)

References 33 publications

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“…Regarding the hospitalization expenses of different age groups, our statistical analysis results showed that the hospitalization expenses of group over 60 y were higher than those in the group under 30 y. comorbidity [30]. The research of Negin found that the rates of chronic disease were higher among older adults compared with those aged 18-49 y.…”

Section: Influencing Factors Of Totalexp and Oopsmentioning

confidence: 71%

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How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011 "

Zhan

Zang³

et al. 2019

Preprint

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Background: The problem of AIDS response has not only involved public health, but also had a great impact on the family burden.The objective of this study was to estimate the preventive and curative care expenditure(PCE)for AIDS of Hunan Province in 2017 based on System of Health Accounts 2011(SHA2011)by quantity,financing scheme,health provider,health function,and to analyses the factors affecting patients' medical burden.Methods: Through stratified multi-stage sampling method, 1336 institutions were surveyed to obtain AIDS prevention and control data, and the official data collected from Health Statistical Yearbook, Health Financial Annual Reports and Government Input Monitoring System were used to estimate the AIDS PCE based on SHA2011. Univariate analyses and ordered logistic regression were used to evaluate the factors affecting the medical burden of AIDS patients.Results: The AIDS PCE of Hunan Province in 2017 was 266.67 million, mainly flowed to hospitals and disease prevention and control institutions. The proportions of curative care expenditure(CCE) and prevention expenditure were 51.39% and 48.61% respectively. Prevention expenditure were mainly used for traditional prevention methods. All prevention expenditure and 88.52% of CCE were borne by public financing scheme. Family health expenditure accounted for 11.12% of CCE but there were still some people with heavy burden of treatment. Non insurance, coinfection and length of stay are risk factors to the total hospitalization expenses(Totalexp)and the outof-pocket payments(OOPs)(all p <0.05,OR>1). Taking the age group under 30 as the reference, the partial regression coefficient of the age group over 60 was statistically significant (OR (Totalexp) =1.809, OR (OOPs) =0.30).Conclusion:The financing structure of the PCE for AIDS in Hunan Province was relatively stable and the flow of institutions was reasonable. The functional flow of expenditure embodied the principle of "prevention first". China should incorporate oral PrEP into the national guidelines as soon as possible to improve the allocation efficiency of AIDS prevention resources. Meantime, several measures should be taken to reduce the medical burden of AIDS patients, including expanding the scope of government assistance, adjusting insurance compensationmeasures, increasing the rate of patients participating in insurance,encouraging commercial insurance to join the AIDS insurance system,and controlling length of stay in hospital.

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Section: Influencing Factors Of Totalexp and Oopsmentioning

confidence: 71%

“…showed the results of ordered logistic regression analysis about Totalexp and OOPs. Taking the group under 30 as the reference, the partial regression coefficient of the age group over 60 was statistically significant, OR(Totalexp)=1.809, OR(OOPs)=0 30…”

mentioning

confidence: 97%

How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011 "

Zhan

Zang³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Once clinical symptoms occur, the treatment becomes more difficult and costly. Meanwhile, the elderly with AIDS are at the high risk of comorbidity [30]. The research of Negin found that the rates of chronic disease were higher among older adults compared with those aged 18-49 y.…”

Section: Discussionmentioning

confidence: 99%

How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011"

Han-hui

Zang

et al. 2020

BMC Public Health

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Background: The problem of AIDS response has not only involved public health, but also had a great impact on the family burden.The objective of this study was to estimate the preventive and curative care expenditure(PCE)for AIDS of Hunan Province in 2017 based on System of Health Accounts 2011(SHA2011)by quantity,financing scheme, health provider,health function,and to analyses the factors affecting patients' medical burden. Methods: Through stratified multi-stage sampling method, 1336 institutions were surveyed to obtain AIDS prevention and control data, and the official data collected from Health Statistical Yearbook, Health Financial Annual Reports and Government Input Monitoring System were used to estimate the AIDS PCE based on SHA2011. Univariate analyses and ordered logistic regression were used to evaluate the factors affecting the medical burden of AIDS patients. Results: The AIDS PCE of Hunan Province in 2017 was 266.67 million, mainly flowed to hospitals and disease prevention and control institutions. The proportions of curative care expenditure(CCE) and prevention expenditure were 51.39 and 48.61% respectively. Prevention expenditure were mainly used for traditional prevention methods. All prevention expenditure and 88.52% of CCE were borne by public financing scheme. Family health expenditure accounted for 11.12% of CCE, but there were still some people with heavy burden of treatment. Non insurance, coinfection and length of stay are risk factors to the total hospitalization expenses(Totalexp)and the out-of-pocket payments(OOPs)(all p < 0.05,OR > 1). Taking the age group under 30 as the reference, the partial regression coefficient of the age group over 60 was statistically significant (OR (Totalexp) = 1.809, OR (OOPs) = 0.30). Conclusion: The financing structure of the PCE for AIDS in Hunan Province was relatively stable and the flow of institutions was reasonable. The functional flow of expenditure embodied the principle of "prevention first". China should incorporate oral PrEP into the national guidelines as soon as possible to improve the allocation efficiency of AIDS prevention resources. Meantime, several measures should be taken to reduce the medical burden of AIDS patients, including expanding the scope of government assistance, adjusting insurance compensation measures, increasing the rate of patients participating in insurance,encouraging commercial insurance to join the AIDS insurance system,and controlling length of stay in hospital.

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“…Another important finding in this study is that older participants who are living with HIV were more likely to report a recent visit to a health-care facility compared with their HIV negative counterparts (MRC/UVRI, 2011). A recent study conducted in South Africa that looked at both private and public health facilities found that private outpatient health services were accessed more by people living with HIV compared with HIV negative respondents (Negin et al., 2016). Previous studies conducted in this population have shown that the majority of older persons living with HIV are enrolled in care, and the majority of these are receiving ART; Negin et al., 2013).…”

Section: Discussionmentioning

confidence: 99%

Timing of Most Recent Health Care Visit by Older People Living With and Without HIV

Mugisha

Schatz

Negin

et al. 2016

Int J Aging Hum Dev

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The objective of this article is to document factors associated with the recency of health-care service utilization by people aged 50 years and over living with and without HIV in Uganda. A survey was conducted with 510 Ugandans aged 50 and older, living with and without HIV. The survey included information on sociodemographic characteristics, health state, self-reported chronic conditions, and timing of most recent visit to a health-care facility (time since last visit [TSLV]). We use ordinal logistic regression to identify independent factors associated TSLV. Independent factors associated with TSLV (>6 months) include age, OR = 2.40 [95% CI 1.08-5.37] for those aged 80 years and above, urban respondents, OR = 0.6 [95%CI 0.38-0.94], HIV-positive respondents, OR = 0.33 [95%CI 0.18-0.59], and better health. To understand the meaning of these finding, further investigation should examine (a) how best to define and measure older persons' health-care service needs and (b) older persons' decision-making processes around the timing of their access to health-care facilities.

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Health expenditure and catastrophic spending among older adults living with HIV

Cited by 19 publications

References 33 publications

How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011 "

How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011 "

How were situations of preventive and curative care expenditure for AIDS and medical burden of patients? Research based on "System of Health Accounts 2011"

Timing of Most Recent Health Care Visit by Older People Living With and Without HIV

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