Cost and economic burden of illness over 15 years in Nepal: A comparative analysis
Publication Date
April 04, 2018
Authors
Khin Thet Swe, Md. Mizanur Rahman, Md. Shafiur Rahman, Eiko Saito, et al
Volume
13
Issue
4
Pages
e0194564
DOI
https://dx.plos.org/10.1371/journal.pone.0194564
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0194564
Scopus
85045059176
Mendeley
http://www.mendeley.com/research/cost-economic-burden-illness-15-years-nepal-comparative-analysis
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Mendeley | Further Information

{"title"=>"Cost and economic burden of illness over 15 years in Nepal: A comparative analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Khin", "last_name"=>"Thet Swe", "scopus_author_id"=>"57201477850"}, {"first_name"=>"Md", "last_name"=>"Mizanur Rahman", "scopus_author_id"=>"56336553600"}, {"first_name"=>"Md", "last_name"=>"Shafiur Rahman", "scopus_author_id"=>"57201483351"}, {"first_name"=>"Eiko", "last_name"=>"Saito", "scopus_author_id"=>"36145372300"}, {"first_name"=>"Sarah K.", "last_name"=>"Abe", "scopus_author_id"=>"57201477842"}, {"first_name"=>"Stuart", "last_name"=>"Gilmour", "scopus_author_id"=>"8561716600"}, {"first_name"=>"Kenji", "last_name"=>"Shibuya", "scopus_author_id"=>"57200173501"}], "year"=>2018, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"621545629", "doi"=>"10.1371/journal.pone.0194564", "issn"=>"19326203", "scopus"=>"2-s2.0-85045059176", "sgr"=>"85045059176"}, "id"=>"6888b7b6-20f4-36ec-adfe-a62e2c49645c", "abstract"=>"© 2018 Swe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background With an increasing burden of non-communicable disease in Nepal and limited progress towards universal health coverage, country- and disease-specific estimates of financial hardship related to healthcare costs need to be evaluated to protect the population effectively from healthcare-related financial burden. Objectives To estimate the cost and economic burden of illness and to assess the inequality in the financial burden due to catastrophic health expenditure from 1995 to 2010 in Nepal. Methods This study used nationally representative Nepal Living Standards Surveys conducted in 1995 and 2010. A Bayesian two-stage hurdle model was used to estimate average cost of illness and Bayesian logistic regression models were used to estimate the disease-specific incidence of catastrophic health payment and impoverishment. The concentration curve and index were estimated by disease category to examine inequality in healthcare-related financial hardship. Findings Inflation-adjusted mean out-of-pocket (OOP) payments for chronic illness and injury increased by 4.6% and 7.3%, respectively, while the cost of recent acute illness declined by 1.5% between 1995 and 2010. Injury showed the highest incidence of catastrophic expenditure (30.7% in 1995 and 22.4% in 2010) followed by chronic illness (12.0% in 1995 and 9.6% in 2010) and recent acute illness (21.1% in 1995 and 7.8% in 2010). Asthma, diabetes, heart conditions, malaria, jaundice and parasitic illnesses showed increased catastrophic health expenditure over time. Impoverishment due to injury declined most (by 12% change in average annual rate) followed by recent acute illness (9.7%) and chronic illness (9.6%) in 15 years. Inequality analysis indicated that poorer populations with recent acute illnesssuffered more catastrophic health expenditure in both sample years, while wealthier households with injury and chronic illnesses suffered more catastrophic health expenditure in 2010. Conclusion To minimize the economic burden of illness, several approaches need to be adopted, including social health insurance complemented with an upgraded community-based health insurance system, subsidy program expansion for diseases with high economic burden and third party liability motor insurance to reduce the economic burden of injury.", "link"=>"http://www.mendeley.com/research/cost-economic-burden-illness-15-years-nepal-comparative-analysis", "reader_count"=>8, "reader_count_by_academic_status"=>{"Student > Doctoral Student"=>1, "Researcher"=>1, "Student > Bachelor"=>5, "Student > Ph. D. Student"=>1}, "reader_count_by_user_role"=>{"Student > Doctoral Student"=>1, "Researcher"=>1, "Student > Bachelor"=>5, "Student > Ph. D. Student"=>1}, "reader_count_by_subject_area"=>{"Medicine and Dentistry"=>6, "Economics, Econometrics and Finance"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>6}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}}, "group_count"=>0}

Scopus | Further Information

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