The household economic burden of non-communicable diseases in 18 countries
BMJ Glob Health
; 5(2): 1-13, Feb., 2020. graf., tab.
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1052967
Biblioteca responsável:
BR79.1
Localização: 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)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
/
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
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Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
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Doença Cardiovascular
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Doenças do Sistema Endócrino
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Sistemas de Saúde
/
Doenças Cardiovasculares
/
Seguro Saúde
Tipo de estudo:
Avaliação econômica em saúde
/
Fatores de risco
Idioma:
Inglês
Revista:
BMJ Glob Health
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Aga Khan University/PK
/
Chinese Academy of Medical Sciences and Peking Union Medical College/CN
/
Dante Pazzanese Institute of Cardiology/BR
/
ECLA Foundation/AR
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Eternal Heart Care Centre and Research Institute/IN
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Faculty of Public Health and Policy/GB
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Hamilton Health Sciences and McMaster University/CA
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Health Action by People/IN
/
Independent University/BD
/
Institut Universitaire de Cardiologie et de Pneumologie de Québec/CA