جستجوی مقالات مرتبط با کلیدواژه « financial burden » در نشریات گروه « پزشکی »

Since 2001, when Uganda abolished user fees to improve the accessibility of healthcare, out-of-pocket costs still account for 42% of total health expenditure. Even if universal health coverage (UHC) is achieved on the demandside, government authorities face political and economic challenges due to soaring burden of diseases. Therefore, this study aimed to re-analyze the implementation process according to three pillars by World Health Organization (WHO) based on Korean UHC-related articles. In terms of breadth, the national health insurance (NHI) in Korea UHC was established from 1977 for employees to 1989 for self-employed. In terms of depth, benefit packages in Korea UHC have expanded from essential medical services to expensive care (ultrasono, computerized tomography, etc) including benefit period. Finally, in terms of height of coverage, the government has tried to relieve financial burden of households with catastrophes and enhance benefit plan for major diseases till now. This historical legacy for UHC in Korea can pose lessons to policy-makers in developing countries including Uganda and Ghana.

Given the importance of appropriate use of supplements in children and increasing the effectiveness of the financial resources, this study aimed at investigating the inappropriate use of the supplements. In this cross-sectional study, the data were collected using a researcher made questionnaire. Participants of the study were randomly selected from the cases whose information was available in the integrated health system (SIB). They comprised of 1220 children under two years of age who lived in Qom province. All samples were interviewed in comprehensive health care centers by trained nutritionists obtaining their demographic information including the place of residence, age, income, occupation and educational level, as well as their status of supplements usage. All statistical data were analyzed through SPSS 23. According to the results, it was estimated that 15.15% of financial resources of Iran's health system transformation plan were allocated to the family physician program and 29.11% of its financial resources were wasted. The total waste was   8,615,324,009 Rials (27.87%). Due to the significant percentage of wastage in resources allocated to providing supplements for children under two years of age, it is necessary to design and implement appropriate educational interventions for mothers of under two-year-old children and more precisely monitor the allocation of the resources in this field.

Surgical site infection (SSI) is a challenge for the surgeon. Incidence of SSI reported in literature varies from 0.5% to 15%. Severity of SSI ranges from superficial skin infection to life-threatening condition like septicaemia. It is responsible for increased morbidity, mortality, and economic burden to the hospital in general, and the patient in particular. The aim of this study was to assess the risk factors, bacteriological profile, length of hospitalization, and cost due to orthopaedic SSI in patients admitted to a tertiary care hospital.

This was a prospective case control study. Cases were diagnosed based on CDC definition of nosocomial SSI. All cases were assessed preoperatively, intraoperatively and postoperatively, according to type of surgery, wound class, duration of operation, antimicrobial prophylaxis, use of drain, preoperative hospital stay, causative micro organism, total hospital stay, re-admission rates and cost incurred. Age, sex and surgical procedure matched controls without SSI, were also assessed. Chi- square test and Fisher's exact test were used for analysis. P= <0.05 was considered significant.

Out of 1023 patients, 47 cases had SSI, with a rate of 4.6%. Cigarette smoking was a risk factor for SSI (P = 0.0035). The most common etiologic agents were Acinetobacter baumannii and Staphylococcus aureus. Incidence of re- admission among SSI cases was more compared to controls (P= 0.0001). Costs attributable to SSI (Indian Rupees) was Rs 32,542 (17,054 to 87,514) which was significantly more than those without SSI (P= <0.001).

Despite latest surgical amenities, meticulous sterilization protocols and pre-operative antibiotic prophylaxis, SSI continues to be present in healthcare settings. The increase in duration of hospital stay due to SSI adds to additional burden to an already resource-constrained healthcare system.

The present study aims to examine challenges encountered by elderly people in Quetta city of Balochistan. The socio-economic problems faced by elderly and the attitude of family members towards them were explored in this study.

A random sample of 200 respondents comprising both women and men of age 60 years and above was selected and data was collected through semi-structured interview schedule. The data collected has been processed through SPSS and simple frequency designed tables.

The results show several problems were encountered by elderly including discrimination (65%), limited decision making power (44%), acts of neglect and maltreatment from families (42%), verbal and physical abuse (41%), reduced social interaction (68%) and economic dependency (55.5%). These challenges were reported to have serious implications on the lives of elderly.

The findings of this study imply that the majority of problems faced by elderly were largely due to breakdown of traditional family system of the country. To address these issues the attention of the state is needed especially in providing alternative means of living for the elderly who spend their lives in serving the nation. This may include setting up elderly homes, introducing elderly allowances and increasing pension amounts.

Antibiotics contribute to a lot of patients’ treatment. However, improper prescription and wasteful use of antibiotics may lead to various side effects or complications such as medicinal resistance and lack of treatment, resulting in an excessive financial burden. The present study aimed to compare antibiotics prescription pattern and their financial burden before and after intervention based on prophylactic antibiotics guidelines in traumatic surgical sections. This analytical and cross-sectional study was conducted in 2018 on patients undergoing surgery in 4 general, urology, neurosurgery, and orthopedics surgery sections. The sample consisted of 464 patients with traumatic injuries. A researcher-made questionnaire was used as a principal instrument for gathering data. The data was analysed using SPSS (version 21). The accordance of dose, method and kind of prescribed antibiotics with the instructions and guidelines after intervention increased to 29, 5.1 and 28.8%, respectively. There was a significant relationship between dose, method, and kind of prescribed antibiotic before and after the intervention (p <0.05). The financial burden of prescribed antibiotics before and after the intervention was 56400480 and 52789290 IRR, respectively. Based on the results, the intervention was effective in accordance with dose, method and kind of prescribed antibiotics. Also, financial burden reduced by 6.4% after the intervention. Continuous monitoring of antibiotic prescription based on instructions, training instructions of prophylaxis antibiotics to physicians, and infectious monitoring committee meetings can prevent irrational prescriptions and reduce the excessive financial burden on society, government and insurance organizations.

The significance of rabies is due to high mortality rate, economic damage caused by livestock loss, and high costs of treatment. Considering the economic problems in developing countries as well as the lack of resources and facilities, economic assessments will be very useful in obtaining the necessary financial information. Therefore, the present study aims to estimate the cost of prevention and control of rabies in Ahar, East Azarbaijan, during 2010-2011 and 2011-2012. This is a descriptive, cross-sectional study conducted in Ahar, East Azarbaijan. This study was carried out using available documents (Vaccine registries, Human Resources Department records, Staff daily wages) and data collection (Ministry of Health and Medical Education, Taxi Administration, Municipality Office and the Veterinary Network) to estimate the cost of prevention and control of rabies during 2010-2011 and 2011-2012. The societal perspective was taken into account to estimate costs. Data was entered into SPSS version 20 and the total cost was calculated. Also, the Mann-Whitney U test was used for data analysis. The total financial burden of preventing and controlling rabies in Ahar during 2010-2011 and 2011-2012 was about 803 and 850 million rials respectively. The loss of the patient's income (240 and 260 million rials during 2010-2011 and 2011-2012), cost of rabies vaccine (approximately 231 and 237 million rials during 2010-2011 and 2011-2012), and staff costs (approximately 118 and 247 million rials during 2010-2011 and 2011-2012) had the largest share of the cost, while cost of tetanus vaccine (1.3 and 1.2 million rials during 2010-2011 and 2011-2012) had the smallest share. The present study showed that the prevention and control of rabies put a significant financial burden on the government through direct medical expenses, rabies control program for dogs, and care of the disease. It put a burden on the people, as well, through the loss of productivity and income, and transportation costs

In recent years, financial coverage and availability of new and expensive
cancer drugs have changed into one of the challenges of the health system, especially
in low-income and middle-income countries,. We studied the availability of
anticancer drugs, insurance coverage and the financial burden of these drugs in Iran.
In this cross-sectional descriptive study, first, we listed effective cancer
drugs according to the World Health Organization’s Model List of Essential Medicines
and previous studies. Then, we evaluated financial burden of these drugs by
using the available data in Iran pharmaceutical Pharmacopoeia, the national pharmaceutical
sales statistics database (pharmaceutical Amarnameh), and inquiry of the
insurance organizations, the availability, insurance coverage in Iran. Excel software
was used for data analysis.
All of the medicines incorporated into the latest version of the WHO Model
List of Essential Medicines were available in Iran, and, except for Bendamustine and
Anastrazole all medicines were covered by insurance. In addition, of the 19 drugs,
those were not on the WHO Model List of Essential Medicines, there were seven
drugs in Iran, insurance covered that six drugs. The total Dollar sales of the studied
cancer drugs amounted to US$350.85 million in 2015 and US$384.96 million in 2016.
It seems that the status of access to effective cancer drugs in Iran is betterthan many low and middle-income countries. However, since the cost of cancer
drugs is rising, health policy makers inevitably need to prioritize cancer drugs by
using the results of health technology assessment methods and provide patients with
access to drugs that are cost-effective in order to the optimal allocation of limited
resources and provide maximum access to cancer drugs throughout the country.

Investigating the conditions and the appropriateness of admission of patients in hospitals is an important issue which can improve the efficiency of health care delivery. Intensive care unit (ICU) is important due to applying expensive financial sources; therefore, its efficient application is of great priority. In this regard, the current study aimed to determine the financial burden of inappropriate admissions in internal intensive care units (IICUs)..
It was a cross-sectional study conducted in 2014. A total of 294 patients admitted to IICUs of Shahid Faghihi and Nemazee hospitals of Shiraz, Iran, in 2012 were enrolled into this retrospective study. The study was conducted in two phases, using the guidelines of American critical care association (ACCA) and experts’ opinion to investigate the financial burden of inappropriate admissions in IICUs of the above-mentioned hospitals..
The results showed no statistically significant relationships among insurance status, insurance type, age, gender and inappropriate admission by applying Chi-square. Among 294 admitted patients under the study, the inappropriate admissions were 11.2% based on the guidelines and 13.6% based on the experts’ opinion. The level of agreement of the guidelines and experts’ opinion for the inappropriate admissions was 0.076 based on Kappa coefficient. The total financial burden imposed on the insurance agencies and the patients by inappropriate admissions was US$ 47867.78 based on the guidelines and US$ 83241.68 based on the experts’ opinion..
Inappropriate admissions to ICUs may impose additional costs to the health system and the patients on one hand, and deprives other patients from receiving health services. Therefore, it is crucial to effectively plan for the application of ICU beds..