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Ladwig, Karl‐Heinz; Marten‐Mittag, Birgitt; Formanek, Bertold; Dammann, Gerhard

doi:10.1023/a:1007629920752

Cited by 263 publications

(79 citation statements)

References 24 publications

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“…It was also found that no age and sex specific pattern on healthcare expenditure exists in Bangladesh (Figure 1) which also similar with the findings of other studies (Gómez 2002; Ladwig et al 2000). A number of studies observed that sex and reproductive biology and mortality to male–female differences in the use of health care services, which also reflected in the current study (Mustard et al 1998; Roos et al 1987).…”

Section: Discussionsupporting

confidence: 89%

The impact of age and sex on healthcare expenditure of households in Bangladesh

et al. 2014

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The impact of age and sex on health care expenditure has recently become one of the major concerns in many developing countries like Bangladesh. Age and sex differences in the use of health care services can be substantial at several stages of life which are reflected in overall healthcare expenditure.We examined the impact of age and sex of the population on overall healthcare expenditure of households in Bangladesh.A total of 10,705 populations who spent for receiving any type of healthcare services were analyzed from Bangladesh Household Income and Expenditure Survey data, 2010. Sex and age group were considered as childhood (0–19), young adult (20–39), middle-aged adult (40–64), senior aged (65–84) and old senior aged (84+) for the entire analysis. Total healthcare expenditure was derived by considering direct cost such as physician’s fee, cost of medicine, diagnostic, transportation, tips and informal payment etc. Indirect and intangible cost was not considered in the analysis.The study found that overall health care expenditure of male (US$ 11.5) is higher than female (US$ 11.2) while this is higher for female (US$ 14.2) than male (US$ 11.3) in the reproductive age. The highest health expenditure was observed in male (US$ 69.7) of age 65–69 years and in female (US$ 23.4) of age 75–79 years. The cost for hospitalization was significantly higher (US $23.7) for female than male (US$ 21.1). Overall health expenditure was observed to be significantly higher in elderly than younger people.These findings provide an experimental framework for the continuing inquiry of equity in the allocation of health care expenditure between male and female at different age, which suggest current health care system in Bangladesh place a significant financial strain on the elderly population.

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Section: Discussionsupporting

confidence: 89%

The impact of age and sex on healthcare expenditure of households in Bangladesh

et al. 2014

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“…This confirms and extends the gender difference reported in previous studies that did not focus solely on chronic symptoms 45 7 8 38 In contrast, Hellström et al 39 did not report any gender difference in the number of symptoms. In their study, Ladwig et al 7 suggest that the gender gap may be mediated by a lower socioeconomic status and higher levels of chronic distress in women.…”

Section: Discussionsupporting

confidence: 87%

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

et al. 2017

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ObjectivesThe burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact.DesignA large cross-sectional population-based study.SettingCommunity in 2 regions of French-speaking Switzerland.ParticipantsCommunity-dwelling older adults aged 68 years and older in 2011 (N=5300).OutcomesDisability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6 months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life.ResultsOnly 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose–response relationships. Joint pain and back pain had the highest population attributable fractions.ConclusionsChronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic symptoms represent good targets for preventive interventions.

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“…26,30,33 In addition, women were more likely to seek the health services in PHC institutions because of low socioeconomic status. 34 Second, the proportion of low- and middle-income groups was 63.70%. This study indicated that they were more likely to utilize the health care services.…”

Section: Discussionmentioning

confidence: 95%

Patients’ Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China

Gan

Cao

et al. 2016

Medicine

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The gate-keeping function of primary healthcare facilities has not been fully implemented in China. This study was aiming at assessing the willingness on community health centers (CHCs) as gatekeepers among a sample of patients and investigating the influencing factors.A cross-sectional survey was conducted in 2013. A total of 7761 patients aged 18 to 90 years from 8 CHCs in Shenzhen (China) were interviewed using a structured questionnaire. Descriptive and multivariable logistic regression analyses were used to analyze the characteristics of patients, their willingness on the gatekeeper policy, and identify the associated factors.On willingness of patients to select CHCs as gatekeepers, 70.03% of respondents were willing, 18.95% were neutral, and 9.02% were unwilling. Multivariable analysis indicated that female patients (odds ratio [OR] = 1.15, 95% confidence interval [CI]: 1.02–1.30); patients with health insurance (OR = 1.21, 95% CI: 1.07–1.36); patients who lives near CHC (OR = 1.89, 95% CI: 1.17–3.05); and patients who were more familiar with the gatekeeper policy (OR = 2.09, 95% CI: 1.85–2.36), had higher level of willingness on the policy. Conversely, reporting with good health status was independently associated with the decreased willingness on gatekeeper policy (OR = 0.69, 95% CI: 0.53–0.90).The findings indicated that patients’ willingness on CHCs as gatekeepers is high. More priority measures, such as expanding medical insurance coverage of patients, strengthening the propaganda of gatekeeper policy, and increasing the access to community health service, are warranted to be taken. This will help to further improve the patients’ willingness on CHCs as gatekeepers. It is thus feasible to implement the gatekeeper policy among patients in China.

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Untitled

Cited by 263 publications

References 24 publications

The impact of age and sex on healthcare expenditure of households in Bangladesh

The impact of age and sex on healthcare expenditure of households in Bangladesh

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

Patients’ Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China

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