Out-of-pocket expenditure on non-communicable diseases during Covid-19. A cross-sectional study from a semi-urban area of Kannur, Kerala

Mathew, Resmi; Olickal, Jeby Jose

doi:10.1016/j.cegh.2022.101210

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…The median cost of availing care for NCDs in private healthcare facilities was 20 times that of public healthcare facilities. 39 For COVID-19, 20.3% of all hospitalisations, and 59% of hospitalisations in private hospitals led to catastrophic health expenditure (CHE). 40 In Ethiopia, the incidence of missed appointments more than doubled for diabetes, hypertension, asthma, chronic kidney disease, cardiac illness, and cancer, majorly due to the challenges of accessibility and affordability.…”

Section: Resultsmentioning

confidence: 99%

Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond

Kodali¹

2023

RMHP

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Background Achieving universal health coverage (UHC) is critical for ensuring equity, improving health, and protecting households from financial catastrophe. The COVID-19 pandemic derailed the progress made across primary health targets. This article aims to review the policy challenges to achieve UHC in a post-pandemic world. Methods A narrative review of 118 peer reviewed and grey literature was conducted. A total of 77 published articles were identified using an electronic search in PubMed and Scopus and a bibliographic search of relevant literature. Another 41 Reports, websites, blogs, news articles, and data were manually sourced from international agencies (WHO, World Bank, IMF, FAO, etc.), government agencies, and non-government organizations. Findings The challenges were identified and discussed under five broad findings: i) weak public health care systems ii) challenges to building resilient health systems, iii) health care financing and financial risk protection, iv) epidemiological and demographic challenges, and v) governance and leadership. Conclusion LMICs in Africa and South Asia face significant challenges to achieving UHC by 2030. As countries recover from the pandemic’s aftermath, significant investments and innovations are needed to ensure progress toward UHC. Efficient resource mobilization through internal accruals, international cooperation, and resource sharing is needed.

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Section: Resultsmentioning

confidence: 99%

Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond

Kodali¹

2023

RMHP

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“…This is the first Indian study to report the total direct cost of care per NCD patient. Earlier studies on NCD care [19]. A recent Indian study on cost of ambulatory care at a public tertiary hospital has reported that the median monthly input cost for diabetes mellitus was INR 804 per patient [48].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, availability of information on cost of healthcare in India has improved. Some studies have reported the high economic burden of NCDs in terms of out-of-pocket expenditure (OOPE) and catastrophic health expenditure for those utilising care from private sector providers [19][20][21][22]. Multiple studies conducted in different states of India have reported the input costs incurred by public facilities [23][24][25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Cost of Care for Non-communicable Diseases: Which Types of Healthcare Providers are the Most Economical in India’s Chhattisgarh State?

Garg,

Tripathi,

Bebarta

2024

PharmacoEconomics Open

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Background Non-communicable diseases (NCDs) affect a large number of people globally and their burden has been growing. Healthcare for NCDs often involves high out-of-pocket expenditure and rising costs of providing services. Financing and providing care for NCDs have become a major challenge for health systems. Despite the high burden of NCDs in India, there is little information available on the costs involved in NCD care. Methods The study was aimed at finding out the average monthly cost of outpatient care per NCD patient. The average cost was defined as all resources spent directly by government and citizens to get a month of care for a NCD patient. The cost borne by the government on public facilities was taken into account and activity-based costing was used to apportion it to the function of providing outpatient NCD care. For robustness, time-driven activity-based costing and sensitivity analyses were also performed. The study was conducted in Chhattisgarh State and involved a household survey and a facility survey, conducted simultaneously at the end of 2022. The surveys had a sample representative of the state, covering 3500 individuals above age of 30 years and 108 health facilities. ResultsThe average monthly cost per NCD patient was Indian Rupees (INR) 688 for public providers, INR 1389 for formal for-profit providers and INR 408 for informal private providers and they managed 53.5, 34.3 and 12.0% of NCD patients respectively. The disease profile of patients handled by different types of providers was similar. The average cost per patient was lowest for the primary care facilities in the public sector. Conclusions The average direct cost of NCD care for government and citizens put together was substantially higher in case of formal for-profit providers compared with public facilities, even after taking into account the government subsidies to public sector. This has implications for allocative efficiency and the desired public-private provider mix in health systems.

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“…Despite worries regarding the use of uneven treatment regimens, pointless diagnostic tests, and exorbitant cost of treatment, private practitioners (PPs), both trained and unskilled, perform a major role in the medical care facility in India. [ 35 36 37 ]…”

Section: Reviewmentioning

confidence: 99%

“The burden of lifestyle diseases and their impact on health service in India”—A narrative review

Sahu,

Kumar,

Nagtode

et al. 2024

Journal of Family Medicine and Primary Care

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Basically, non-communicable diseases (NCDs) are lifestyle diseases. They cannot be transmitted from one person to another person. Instead, our lifestyle, genetics, and environment influence our susceptibility to various diseases. In India, non-communicable illnesses and injuries are responsible for 52% of fatalities. The burden of non-communicable diseases and the resultant mortality are predicted to increase if the government does not take significant steps to prevent and control NCDs and related risk factors. According to the currently available research, the top causes of illness, disability, and death in India include hypertension, cardiovascular diseases, cancer, diabetes, lung disease, chronic renal disease, trauma, stroke, and chronic obstructive and mental disorders. Since 1980s, the Government of India has assisted the states through several vertical programs to prevent and control NCDs. However, efforts to prevent and control NCDs significantly increased under the 11th plan. New programs were launched on a small scale in a select few districts. The financial burden of NCDs has mostly stayed the same, though based on past experiences, reducing exposure to risk factors requires focusing on health promotion and preventative actions. The public healthcare system must have the tools and talents needed for effective management, early diagnosis, and screening. Effective monitoring systems, integrated management, and public awareness campaigns are required to successfully implement the program and make services available to all national citizens.

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Out-of-pocket expenditure on non-communicable diseases during Covid-19. A cross-sectional study from a semi-urban area of Kannur, Kerala

Cited by 4 publications

References 15 publications

Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond

Achieving Universal Health Coverage in Low- and Middle-Income Countries: Challenges for Policy Post-Pandemic and Beyond

Cost of Care for Non-communicable Diseases: Which Types of Healthcare Providers are the Most Economical in India’s Chhattisgarh State?

“The burden of lifestyle diseases and their impact on health service in India”—A narrative review

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