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The household economic burden of non-communicable diseases in 18 countries
Murphy, A; Palafox, B; Walli-Attaei, M; Powell-Jackson, T; Rangarajan, S; Alhabib, K. F; Avezum, A. J; Calik, K. B. T; Chifamba, J; Choudhury, T; Dagenais, G; Dans, A. L; Gupta, R; Iqbal, R; Kaur, M; Kelishadi, R; Khatib, R , , , USA; Kruger, I. M; Kutty, V. R; Lear, S. A; Li, W; Lopez-Jaramillo, P; Mohan, V; Mony, P. K; Orlandini, A; Rosengren, A; Rosnah, I; Seron, P; Teo, K; Tse, L. A; Tsolekile, L; Wang, Y; Wielgosz, A; Yan, R; Yeates, K. E; Yusoff, K; Zatonska, K; Hanson, K; Yusuf, S; McKee, M.
Afiliación
  • Murphy, A; Faculty of Public Health and Policy. Londres. GB
  • Palafox, B; Faculty of Public Health and Policy. Londres. GB
  • Walli-Attaei, M; Hamilton Health Sciences and McMaster University. Ontario. CA
  • Powell-Jackson, T; Faculty of Public Health and Policy. Londres. GB
  • Rangarajan, S; Hamilton Health Sciences and McMaster University. Ontario. CA
  • Alhabib, K. F; King Saud University. Riyadh. SA
  • Avezum, A. J; Dante Pazzanese Institute of Cardiology. São Paulo. BR
  • Calik, K. B. T; Marmara University. Istanbul. TR
  • Chifamba, J; University of Zimbabwe. Harare. ZW
  • Choudhury, T; Independent University. Dhaka. BD
  • Dagenais, G; Institut Universitaire de Cardiologie et de Pneumologie de Québec. Ontario. CA
  • Dans, A. L; University of the Philippines Manila. Manila. PH
  • Gupta, R; Eternal Heart Care Centre and Research Institute. Jaipur. IN
  • Iqbal, R; Aga Khan University. Karachi. PK
  • Kaur, M; Post Graduate Institute of Medical Education and Research. Chandigarh. IN
  • Kelishadi, R; Isfahan University of Medical Sciences. Isfahan. IR
  • Khatib, R , , , USA; Northwestern University Feinberg School of Medicine. Illinois. US
  • Kruger, I. M; North-West University. Potchefstroom. ZA
  • Kutty, V. R; Health Action by People. Trivandrum. IN
  • Lear, S. A; Simon Fraser University. Vancouver. CA
  • Li, W; University Teknologi MARA. Beijing. CN
  • Lopez-Jaramillo, P; Universidad de Santander (UDES). Bucaramanga. CO
  • Mohan, V; Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation. Chennai. IN
  • Mony, P. K; St John's Medical College and Research Institute. Bangalore. IN
  • Orlandini, A; ECLA Foundation. Santa Fe. AR
  • Rosengren, A; University of Gothenburg and Sahlgrenska. Gothenburg. SE
  • Rosnah, I; UKM Medical Centre Kuala. Lumpur. MY
  • Seron, P; Universidad de La Frontera. Temucu. CL
  • Teo, K; Hamilton Health Sciences and McMaster University. Ontario. CA
  • Tse, L. A; The Chinese University of Hong Kong. Hong Kong. CN
  • Tsolekile, L; University of the Western Cape Western. Cape. ZA
  • Wang, Y; Chinese Academy of Medical Sciences and Peking Union Medical College. Beijing. CN
  • Wielgosz, A; University of Ottawa. Ontario. CA
  • Yan, R; Chinese Academy of Medical Sciences and Peking Union Medical College. Beijing. CN
  • Yeates, K. E; Queen's University. Kingston. CA
  • Yusoff, K; Selangor and UCSI University. Kuala Lumpur. MY
  • Zatonska, K; Wroclaw Medical University. Wroclaw. PL
  • Hanson, K; Faculty of Public Health and Policy. Londres. GB
  • Yusuf, S; Hamilton Health Sciences and McMaster University. Ontario. CA
  • McKee, M; Faculty of Public Health and Policy. Londres. GB
BMJ Glob Health ; 5(2): 1-13, Feb., 2020. graf., tab.
Article en En | SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1052967
Biblioteca responsable: BR79.1
Ubicación: BR79.1
ABSTRACT

BACKGROUND:

Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries.

METHODS:

Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group high-income countries (Canada and Sweden), upper middle income countries (UMICs Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs Bangladesh, Pakistan, Zimbabwe and Tanzania) and China.

RESULTS:

The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs.

CONCLUSIONS:

Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs. (AU)
Asunto(s)

Texto completo: 1 Colección: 06-national / BR Base de datos: SES-SP / SESSP-IDPCPROD Asunto principal: Sistemas de Salud / Enfermedades Cardiovasculares / Seguro de Salud Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Idioma: En Revista: BMJ Glob Health Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 06-national / BR Base de datos: SES-SP / SESSP-IDPCPROD Asunto principal: Sistemas de Salud / Enfermedades Cardiovasculares / Seguro de Salud Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Idioma: En Revista: BMJ Glob Health Año: 2020 Tipo del documento: Article