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Health Financial protection

Audur Ketilsdottir, Brynja Ingadottir, Tiny Jaarsma
AIMS: There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). METHODS AND RESULTS: In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care-'Patients' evaluation'), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale)...
October 18, 2018: ESC Heart Failure
Asnakew Molla Mekonen, Measho Gebreslassie Gebregziabher, Alemayehu Shimeka Teferra
INTRODUCTION: Moving towards the goal of universal health coverage requires strengthening service delivery and overcoming significant financial barriers. The Government of Ethiopia is rolling out community based health insurance to protect the rural community from high out of pocket health expenditure and improve health service utilization. We investigated the effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia. METHODS: A community based cross sectional study was conducted...
2018: PloS One
Bolaji Samson Aregbeshola, Samina Mohsin Khan
BACKGROUND: There is high reliance on out-of-pocket (OOP) health payments as a means of financing health system in Nigeria. OOP health payments can make households face catastrophe and become impoverished. The study aims to examine the financial burden of OOP health payments among households in Nigeria. METHODS: Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/2010 was utilized to assess the catastrophic and impoverishing effects of OOP health payments on households in Nigeria...
March 10, 2018: International Journal of Health Policy and Management
Ole F Norheim
How can evidence from economic evaluations of the type the Disease Control Priorities project have synthesized be translated to better priority setting? This evidence provides insights into how investing in health, particularly though priority interventions and expanded access to health insurance and prepaid care, can not only save lives but also help alleviate poverty and provide financial risk protection. The article discusses some of the relevant factors needed to develop a Theory of Change for translating economic evidence to better priority setting within countries, and proposes some key strategic choices that are necessary to achieve the desired outputs and outcomes...
June 30, 2018: International Journal of Health Policy and Management
Irene A Agyepong
Will the Sustainable Development Goal 3 sub-goal "Achieve universal health coverage, including financial risk protection, access to quality essential health care services and…safe, effective, quality and affordable essential medicines and vaccines for all" be judged a breakthrough or a great white elephant in implementation, when we look back with the clear eyes of hindsight in 2030? What are the ways in which this agenda might play out in implementation and why might it do so? Drawing on a desk review, this Essay explores dominant ideas, ideology, institutions, and interests in relation to global versus Ghana national health priorities since the WHO constitution came into effect in 1948, to reflect on these questions...
October 5, 2018: Lancet
Shashi Mawar, Pity Koul, Smita Das, Sanjay Gupta
Context: Elder abuse is a serious problem that has adverse consequence on health. Still, research on elder abuse is sparse in India. Aims: This study aimed to find the nature, prevalence, and factors such as depression and physical problems associated with elder abuse in an urban North Indian community. Materials and Methods: A cross-sectional study was conducted with 222 elders with 97 males, aged 60 years or older residing in an urban community of Delhi...
July 2018: Indian Journal of Community Medicine
Tienke Vermeiden, Rita Schiffer, Jorine Langhorst, Neel Klappe, Wolde Asera, Gashaw Getnet, Jelle Stekelenburg, Thomas van den Akker
OBJECTIVE: To describe facilitators for maternity waiting home (MWH) utilization from the perspectives of MWH users and health staff. METHODS: Data collection took place over several time frames between March 2014 and January 2018 at Attat Hospital in Ethiopia, using a mixed-methods design. This included seven in-depth interviews with staff and users, three focus group discussions with 28 users and attendants, a structured questionnaire among 244 users, a two-week observation period, and review of annual facility reports...
October 4, 2018: Tropical Medicine & International Health: TM & IH
Ulrika Rehnström Loi, Matilda Lindgren, Elisabeth Faxelid, Monica Oguttu, Marie Klingberg-Allvin
BACKGROUND: Unwanted pregnancies and unsafe abortions are prevalent in regions where women and adolescent girls have unmet contraceptive needs. Globally, about 25 million unsafe abortions take place every year. In countries with restrictive abortion laws, safe abortion care is not always accessible. In Kenya, the high unwanted pregnancy rate resulting in unsafe abortions is a serious public health issue. Gaps exist in knowledge regarding women's decision-making processes in relation to induced abortions in Kenya...
October 3, 2018: Reproductive Health
Antoniya Dimova, Maria Rohova, Stefka Koeva, Elka Atanasova, Lubomira Koeva-Dimitrova, Todorka Kostadinova, Anne Spranger
This analysis of the Bulgarian health system reviews developments in its organization and governance, health financing, health care provision, health reforms and health system performance. With the 2015 National Health Strategy 2020 at its core, there have been ambitious reform plans to introduce more decentralization, strategic purchasing and integrated care into the Bulgarian social health insurance system. However, the main characteristics of the Bulgarian health system, including a high level of centralization and a single payer to administer social health insurance, remain intact and very few reforms have been implemented (for example, the introduction of health technology assessment)...
September 2018: Health Systems in Transition
Dan Myles, Adrian Carter, Murat Yücel
Video slot machines are associated with both an accelerated transition into problematic forms of gambling, as well as psychosocial harm above and beyond other forms of gambling. A growing body of evidence is uncovering how key design features of multi-line slot machines produce an inflated experience of reward, despite the fact that these features offer no overall financial benefit to the player. A pernicious example of this are "losses disguised as wins" (or LDWs), which occur when simultaneous bets placed on multiple lines result in a winning combination that returns an amount greater than zero, but less the total wager...
October 1, 2018: European Journal of Neuroscience
Sarah K Westcott, Leila Y Beach, Fumika Matsushita, Christine M Albert, Neal Chatterjee, Jorge Wong, David R Williams, Manickavasagar Vinayagamoorthy, Julie E Buring, Michelle A Albert
Negative emotions have been linked to the development of atrial fibrillation (AF), and positive effect may be protective. However, there are few large-scale studies examining the association between psychosocial stressors that may provoke these emotions and the occurrence of AF. We examined the cross-sectional relation between psychosocial stress and AF in 24,809 women participating in the Women's Health Study. Participants answered questions about work stress (e.g., excessive work, conflicting demands), work-family spillover stress (e...
August 17, 2018: American Journal of Cardiology
Tim K Mackey, Taryn Vian, Jillian Kohler
Corruption is diverse in its forms and embedded in health systems worldwide. Health-sector corruption directly impedes progress towards universal health coverage by inhibiting people's access to quality health services and to safe and effective medicines, and undermining systems for financial risk protection. Corruption is also a cross-cutting theme in the United Nations' sustainable development goals (SDGs) which aim to improve population health, promote justice and strong institutions and advance sustainable human development...
September 1, 2018: Bulletin of the World Health Organization
Hui Wang, Lluis Vinyals Torres, Phyllida Travis
Objective: To document the financial protection status of eight countries of the South-East Asian region and to investigate the main components of out-of-pocket expenditure on health care. Methods: We calculated two financial protection indicators using data from living standards surveys or household income and expenditure surveys in Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste. First, we calculated the incidence of catastrophic health expenditure, defined as the proportion of the population spending more than 10% or 25% of their total household expenditure on health...
September 1, 2018: Bulletin of the World Health Organization
Mary Qiu, Nasreen Jessani, Sara Bennett
BACKGROUND: There is an established body of evidence linking systems of social protection to health systems and health outcomes. The Sustainable Development Goals (SDGs) provide further emphasis on this linkage as necessary to achieving health and non-health goals. Existing literature on social protection and health has focused primarily on cash transfers. We sought to identify potential research priorities concerning social protection and health in low and middle-income countries, from multiple perspectives...
September 27, 2018: International Journal for Equity in Health
Veronica Vargas, Sayem Ahmed, Alayne M Adams
INTRODUCTION: Maternal delivery is the costliest event during pregnancy, especially if a complicated delivery occurs that requires emergency hospital services. A health financing scheme or program that covers comprehensive maternal services, including specialized hospital services in the benefits health package, enhances maternal survival and improves financial risk protection. OBJECTIVES: The objective of this study is to identify factors that enable the inclusion of comprehensive maternal services in the benefits package of emerging health financing schemes in low and middle-income countries across selected world regions...
2018: PloS One
David Orentlicher
Physicians assume a primary ethical duty to place the welfare of their patients above their own interests. Thus, for example, physicians must not exploit the patient-physician relationship for personal financial gain through the practice of self-referral. But how far does the duty to patient welfare extend? Must physicians assume a serious risk to their own health to ensure that patients receive needed care? In the past, physicians were expected to provide care during pandemics without regard to the risk to their own health...
November 2018: American Journal of Public Health
Shalin G Gala, Marie L Crandall
BACKGROUND: Each year, thousands of surgeons and other trauma health care providers participate in the American College of Surgeon's Advanced Trauma Life Support (ATLS) program, which historically has allowed trainees to practice cricothyroidotomy, chest tube insertion, pericardiocentesis, venous cutdown, and diagnostic peritoneal lavage on live dogs, pigs, sheep, and goats. However, more than 99% of ATLS programs in the United States and Canada have now ended animal use, driven primarily by simulation technology advancements...
September 20, 2018: Journal of Surgical Education
Shah Mohammad Fahim, Tofayel Ahmed Bhuayan, Md Zakiul Hassan, Abu Hena Abid Zafr, Farhana Begum, Md Mizanur Rahman, Shahinul Alam
Bangladesh has attained notable progress in most of the health indicators, but still, health system of the country is suffering badly from poor funding. Issues like burden of out-of-pocket expenditure, low per capita share in health, inadequate service facilities, and financial barriers in reducing malnutrition are being overlooked due to inadequacy and inappropriate utilization of allocated funds. We aimed to review the current status of health care spending in Bangladesh in response to national health policy (NHP) and determine the future challenges towards achieving universal health coverage (UHC)...
September 20, 2018: International Journal of Health Planning and Management
Suneela Garg
The realization of Universal Health Coverage requires adequate healthcare financing and human resources to provide financial protection to the economically disadvantaged population by covering their medicine, diagnostics, and service costs. Conventionally, inadequate public healthcare financing and the lack of skilled human resources are considered as the major barriers towards achieving UHC in India. To strengthen the Indian healthcare system, there has been significant increase budgetary allocation towards healthcare, a national health protection scheme targeting low-income households, upgrading of primary health-care and expansion of the health work-force...
July 2018: Indian Journal of Public Health
N Akhter, C Bambra, K Mattheys, J Warren, A Kasim
In response to the 2007/8 financial crisis and the subsequent 'Great Recession', the UK government pursued a policy of austerity, characterised by public spending cuts and reductions in working-age welfare benefits. This paper reports on a case study of the effects of this policy on local inequalities in mental health and wellbeing in the local authority of Stockton-on-Tees in the North East of England, an area with very high spatial and socio-economic inequalities. Follow-up findings from a prospective cohort study of the gap in mental health and wellbeing between the most and least deprived neighbourhoods of Stockton-on-Tees is presented...
December 2018: SSM—Population Health
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