Displaying publications 101 - 120 of 144 in total

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  1. Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region
    Lee ZV, Llanes EJ, Sukmawan R, Thongtang N, Ho HQT, Barter P, et al.
    Lipids Health Dis, 2021 Apr 15;20(1):33.
    PMID: 33858442 DOI: 10.1186/s12944-021-01450-8
    Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
    Matched MeSH terms: Health Care Costs
  2. Fulltext Satisfaction and perceptions of patients toward kidney stones disease management: a review of literature
    Nouri, Ahmed Ibrahim, Hassal, Mohamed Azmi, Allayla, Tuqa Haitham
    Malaysian Journal of Pharmaceutical Science, 2018;16(1):55-60.
    MyJurnal
    Urolithiasis considered as a disease condition that is neglected in terms of research because of its perceived low prevalence and possibly the seemingly good prognosis associated with it. However, in recent years, the prevalence of urolithiasis is increasing in both developed and developing countries and the disease is associated with significant burden and healthcare cost from patients’ caregivers, and society’s perspective. All healthcare providers (including pharmacists) have an important role to play in the management of this disease and it deserves more attention in terms of clinical practice and research. This review aims to provide a comprehensive understanding of patient satisfaction, from the aspect of defining satisfaction of patients, perceptions toward disease management, and a review of literature of satisfaction of patients with kidney stones and its magnitude in healthcare provided. The medical literature has many articles about urolithiasis management options. However, there have been no sufficient published studies discussing patient-reported outcomes of kidney stone management to evaluate their satisfaction, preferences, treatment expectations, and quality of life. Future studies are needed to spot the light on kidney stones patients’ preferences and reported outcomes.
    Matched MeSH terms: Health Care Costs
  3. Fulltext Identifying the nurses’ knowledge and practice on preventing ventilator-associated pneumonia in the intensive care unit, Queen Elizabeth Hospital 2, Sabah
    Patricia Sator, Noorhafizah Ag Riun
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):43-43.
    MyJurnal
    Introduction: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs 48-72 hours or there-after following endotracheal intubation. VAP increased health care costs due to hospital length of stay. Since VAP can be prevented, this study underscores the importance of identifying the current knowledge and practice on the prevention of VAP among the ICU nurses in Queen Elizabeth Hospital 2 (QEH2). The objective of this study is to determine the nurse’s knowledge and practice towards VAP prevention. Methods: The methodology used for this study is a cross-sectional study to evaluate nurses’ knowledge and practice in the ICU, QEH2. 82 ICU QEH2 nurs-es participated. Data were collected using a modified structured questionnaire based on the checklist of VAP data elements. The elements covered in the questionnaire consist of three parts, which are Part A on socio-demographic information, Part B on knowledge ventilator-associated pneumonia events and Part C on nurse’s prevention practice on ventilator-associated events. The data was analyzed using SPSS version 20. Results: The overall results of this study are 45.1% of the nurses were less knowledgeable on VAP prevention and this could lead to a prevalence of VAP in the unit. VAP is a new concept implemented in 2013, meaning that 48.53% (n=33) nurses who trained 2-5 years ago may have not covered VAP in their infection prevention and control training. Most of the ICU nurses did not profoundly practices on subglottic suction (35/82), hand hygiene prior suctioning (40/82), hand hygiene after ETT suction (16/82) and delirium risk assessment (1/82). As a discussion, this could mean the ICU nurses do not have adequate knowledge and practice awareness on VAP prevention. Conclusion: For the conclusion of this study, the nurses working in ICU, QEH2 practiced most of the recommended VAP prevention but not all. Continuous training on prevention for VAP in ICU needs to be review. The hospital management to ensure the availability of the facilities needed and the adoption of guidelines based on evidence-based practice.
    Matched MeSH terms: Health Care Costs
  4. Echinocandins in the treatment of candidaemia and invasive candidiasis: clinical and economic perspectives
    Neoh CF, Slavin M, Chen SC, Stewart K, Kong DC
    Int J Antimicrob Agents, 2014 Mar;43(3):207-14.
    PMID: 24670423 DOI: 10.1016/j.ijantimicag.2013.08.010
    Candidaemia and invasive candidiasis (IC) complicate modern medical therapy, contributing to high morbidity and mortality. Managing candidiasis is costly, with an additional healthcare expenditure of nearly US$300 million annually. Recent consensus guidelines have suggested the use of newer antifungal agents, such as echinocandins, for the treatment of candidaemia and IC owing to promising clinical outcomes compared with older-generation antifungal agents, but at higher drug acquisition and administration costs. Comprehensive cost-effectiveness data for echinocandins in treating candidaemia and IC remain relatively scant, underlining the need for more studies to incorporate robust economic analyses into clinical decisions. Assessment of the cost efficiencies of these expensive antifungal agents is essential for maximising health outcomes within the constraints of healthcare resources. This review will explore the epidemiology of candidaemia and IC in the context of clinical and economic aspects of the antifungal agents used to treat IC, especially the echinocandins. Standardising the outcome measure, methodology and reporting of results used in economic studies is central to ensure validity and comparability of the findings. Future studies comparing the economic advantages of all available antifungal treatment options and in the context of new diagnostic tools for fungal infections are anticipated.
    Matched MeSH terms: Health Care Costs
  5. Fulltext Case mix and cost drivers for cardiology cases in Hospital UKM Cheras Kuala Lumpur
    Amrizal, M.N., Rohaizat, Y.B., Saperi, S., SyedMohamed Aljunid
    Malaysian Journal of Public Health Medicine, 2006;6(1):11-16.
    MyJurnal
    Hospital UKM is the first hospital to implement case·mix system in Malaysia. The objective of the programme is to utilise case-mix system as a tool in improving efficiency and quality of care. From July 2002 to June 2004, a total of 35,568 cases were grouped using IRDRG-Version 1.1 case-mix grouper. Out of these, 3,622 cases or 10.2 % were cardiology cases in MDC 05 (Diseases and Disorders of the Circulatory System). Medical Cardiology cases consist of 86.5% and the remaining 13.5% were Surgical Cardiology. Most of the cases were in severity level one (43.4%), 29.5 % in severity level two and 27.1% in severity level three. The mortality rates for severity level one, two and three were 1.0%, 2.6% and 11.5% respectively. Top three cardiology cases were Acute Myocardial Infarction Without Comorbidity and Complication (IRDRG 05331) (8.4%), Acute Myocardial Infarction With Major Comorbidity and Complication (IRDRG 05333) (7.6%) and Cardiac Catheterization for Ischemic Heart Disease Without Comorbidity and Complication (IRDRG 05311) (7.4%). Step-down costing was carried out to obtain the cost for each DRG group. The mean cost per episode of care for Medical Cardiology cases was RM 3,562 (SD= RM 2, 1 19) with average LOS of 6.4 days (SD= 3 .8days) . For the Surgical Cardiology cases, the mean cost per episode ofcare was RM 6,526 (SD= RM 4,585) and average LOS of5.8 days (SD= 4.1 days). The main components of cost for Medical Cardiology cases are ICU cost (28.8%), pharmacy (17.3%) and Ward Services (15.3%). In Surgical Cardiology, the biggest component of cost was for Operation Theatre (27.9%), followed by Ward Services (25 .4%) and pharmacy (8.5%). Multivariate analysis using multiple linear regression showed that factors which significantly influence the treatment cost of cardiology cases were length of stay, age of the patient, discharge outcome, case type ('surgical partition') and severity level.
    Matched MeSH terms: Health Care Costs
  6. Fulltext Patients' willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation
    Wan Puteh SE, Ahmad SNA, Aizuddin AN, Zainal R, Ismail R
    Asia Pac Fam Med, 2017;16:5.
    PMID: 28392749 DOI: 10.1186/s12930-017-0035-5
    BACKGROUND: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population.
    METHODS: A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses.
    RESULTS: Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP.
    CONCLUSION: The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.
    Matched MeSH terms: Health Care Costs
  7. Fulltext Cost-effectiveness of antihypertensive treatment in Malaysia
    Qais Alefan, M. Izham M. Ibrahim, Tariq Abdul Razak, Azizi Ayub
    Malaysian Journal of Pharmaceutical Science, 2009;7(2):137-152.
    MyJurnal
    Hypertension is a prevalent chronic disease, which is strongly related to the development of cerebrovascular and cardiovascular diseases. The prevalence of hypertension in Malaysia in subjects aged 15 years and above was estimated to be 27.8%. Cost-effectiveness analysis (CEA) compares treatment options with different effectiveness and safety profiles. The utilisation of antihypertensive drugs has raised some concerns about the balance between its costs and benefits. This study was conducted to describe the healthcare costs for hypertensive subjects and to examine the cost-effectiveness of different classes of antihypertensive drugs used in Malaysia. Retrospective and prospective data analysis of a cohort of uncomplicated hypertensive patients was conducted to determine ambulatory health care costs among hypertensive patients groups. The total direct and
    indirect costs of controlled and uncontrolled blood pressure (BP) were described. The health care
    costs ($) / clinical outcome (AC/E ratio) was calculated. Mean total direct costs per patient per month was higher in uncontrolled blood pressure groups compared to the controlled blood pressure groups. The cost-effectiveness relationship was more favourable for diuretics (1.9), angiotensin converting enzyme inhibitors (ACEIs) (2.0), prazosin (2.4) and beta blockers (2.5), more than the diuretics and beta blockers combination theraphy (3.0), calcium channel blockers (CCBs) (3.4) and other combinations (6.1). Antihypertensive drugs used to treat hypertensive patients were different
    in their cost-effectiveness ratios. Such results will allow health care professionals and/or decision
    makers to make better decisions on how to select treatment options for hypertensive patients in
    Malaysia and how to distribute and allocate scarce health care resources. Pharmacoeconomic
    evaluations can help in making difficult choices rationally and allocate scarce resources efficiently.
    Matched MeSH terms: Health Care Costs
  8. Prevention of respiratory distress syndrome
    Yu, Victor Y.H.
    Malaysian Journal of Child Health, 1993;5(1):3-8.
    MyJurnal
    ANTENATAL CORTICOSTEROID THERAPY. Benefits. In 1969, the first study was published which showed that prematurely delivered lambs exposed prenatally to corticosteroids survived longer than placebo-treated control animals.' A randomised clinical trial (RCT) followed which demonstrated that antenatal corticosteroid therapy significantly reduced the incidence of respiratory distress syndrome (RDS) in infants born before 2 weeks gestation and reduced mortality in those born before 37 weeks.2 A meta-analysis has been published on 12 RCTs involving over 3000 women in preterm labour, using primarily 24mg of betamethasone or dexamethasone given in 2-6 divided doses over a 48-hour period.' It showed that antenatal corticosteroid therapy is associated with a significant reduction in the risk of RDS (a) if the infant is born > 24 hours or < 7 days of the treatment, (b) in both male and female infants and (c) even in infants < 31 weeks gestation. It also significantly reduces mortality rate and morbidity such as intraventricular haemorrhage (IVH) and necrotising enterocolitis (NEC), shortens the duration of hospitalisation and reduces treatment costs. The improvement in survival rate in infants born
    Matched MeSH terms: Health Care Costs
  9. Cost-Effectiveness of Periodontitis Management in Public Sector Specialist Periodontal Clinics: A Societal Perspective Research in Malaysia
    Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
    Matched MeSH terms: Health Care Costs
  10. Fulltext Evaluation of the involvement of pharmacists in diabetes self-care: a review from the economic perspective
    Jamshed SQ, Siddiqui MJ, Rana B, Bhagavathula AS
    Front Public Health, 2018;6:244.
    PMID: 30234088 DOI: 10.3389/fpubh.2018.00244
    Objectives: To analyze the studies encompassing the involvement of pharmacists in diabetes self-care.
    Method: We reviewed studies conducted from 2005 to 2017 on the involvement of pharmacists in diabetes self-care. The keywords mainly used in this search are pharmacoeconomic analysis, diabetes self-care, pharmacist involvement,cost-effectiveness analysis, cost of utilization, cost of illness, cost of minimization and cost-benefit analysis. PubMed, Science Direct, Springer Link and Medline searched for the relevant studies. These databases searched for full text articles ranging from 2007 to 2017. We tried to limit the search with the inclusion of studies having any sort of pharmacoeconomically relevant component.
    Key Findings: Cost of illness varied among the countries in managing diabetes mellitus, and the cost of managing diabetes complications were twice the cost of management of diabetes. Continuous involvement of the pharmacist in primary health care is a cost-effective strategy and pronounced to be essential for helping diabetes patient in controlling and managing their disease. Implementation of diabetes self-care by pharmacists such as lifestyle intervention rendered improved quality of life of patient without any increase in health care cost. Self-care management generates intensive blood glucose control and improved quality of life.
    Conclusions: Implementation of diabetic self-care intervention including intensive lifestyle intervention, education, self-monitoring of blood glucose and adherence toward medication-initiated reduction in the overall healthcare cost of diabetic patients compared to patients relying on only any one of the interventions. Impact of diabetes self-care intervention by pharmacist reported to significantly reduce the HbA1C levels of diabetic patients along with the reduction of yearly healthcare cost. This review showed that pharmacist involvement in diabetes self-care interventions prove to be cost-effective and can significantly affect the condition of the diabetic patients and reduces the risk of complications.
    Matched MeSH terms: Health Care Costs
  11. Health Care In Malaysia: The Dynamics Of Provision, Financing And Access
    Chee H L, Barraclough S
    ISBN: 978-0-203-96483-5
    Foreword. M K Rajakumar
    Introduction: The transformation of health care in Malaysia. p1. CHEE HENG LENG AND SIMON BARRACLOUGH
    PART I: The state and the private sector in the financing and provision of health care. p17
    1 The growth of corporate health care in Malaysia. p19. CHEE HENG LENG AND SIMON BARRACLOUGH
    2 Regulating Malaysia’s private health care sector. p40. NIK ROSNAH WAN ABDULLAH
    3 Rising health care costs: the contradictory responses of the Malaysian state. p59. PHUA KAI LIT
    4 Malaysian health policy in comparative perspective. p72. M. RAMESH
    5 The welfarist state under duress: global influences and local contingencies in Malaysia. p85. CHAN CHEE KHOON
    6 Equity in Malaysian health care: an analysis of public health expenditures and health care facilities. p102. WEE CHONG HUI AND JOMO K.S.
    PART II: People’s access to health care. p117
    7 Health care for the Orang Asli: consequences of paternalism and non-recognition. p119. COLIN NICHOLAS AND ADELA BAER
    8 Women’s access to health care services in Malaysia. p137. CHEE HENG LENG AND WONG YUT LIN
    9 HIV/AIDS health care policy and practice in Malaysia. p154. HUANG MARY S.L. AND MOHD NASIR MOHD TAIB
    10 Health care and long-term care issues for the elderly. p170. ONG FON SIM
    11 Health care in Sarawak: model of a public system. p187. KHOO KHAY JIN
    Epilogue: Civil society and health care policy in Malaysia. p208. CHEE HENG LENG AND SIMON BARRACLOUGH
    Index
    Matched MeSH terms: Health Care Costs
  12. Caregivers' perceptions towards oral healthcare services for elders living in Malaysian nursing homes-A qualitative study
    Letchumanan D, Mohamad Norpi N, Yusof ZYM, Razak IA, Abu Kasim NH, Abdullah NA, et al.
    Gerodontology, 2020 Dec;37(4):332-341.
    PMID: 32115787 DOI: 10.1111/ger.12466
    OBJECTIVE: To assess the perceptions of caregivers towards oral healthcare services received by elders in Malaysian nursing homes and to identify challenges and suggestions for improvement.

    BACKGROUND: Caregivers play an important role in the oral health care of elders in nursing homes.

    METHODS: This study employed a qualitative approach using the nominal group technique (NGT) to obtain caregivers' feedback in nursing homes in Malaysia. Data were manually transcribed, summarised into keywords/key phrases, and ranked using weighted scores.

    RESULTS: In total, 36 caregivers (21 from government and 15 from private nursing homes) participated in the NGT sessions. Overall, caregivers were satisfied with the low treatment cost, the quality of treatment, and the availability of dental visits to nursing homes. Caregivers were dissatisfied with the frequency of dental visits, long waiting times at government dental clinics, and inadequate denture hygiene education for elders in nursing homes. The challenges faced by caregivers were elders' poor oral health knowledge and attitude and lack of elders' trust of caregivers to look after their oral health. Suggestions for improvement were to increase the frequency of dental visits to nursing homes, provide oral health education to elders and caregivers, and give treatment priority to elders at dental clinics.

    CONCLUSION: Despite being satisfied with the basic oral healthcare services received by elders in Malaysian nursing homes, caregivers raised some issues that required further attention. Suggestions for improvement include policy changes in nursing home dental visits and treatment priority for elders at government dental clinics.

    Matched MeSH terms: Health Care Costs
  13. Fulltext Effect of Blastocystis sp. in dengue patients-Increase in the treatment cost and exacerbation of symptoms
    Thergarajan G, Kumar S, Bhassu S, Omar SFBS, Rampal S
    PLoS One, 2019;14(3):e0211034.
    PMID: 30893309 DOI: 10.1371/journal.pone.0211034
    Increasing incidences of dengue have become a global health threat with major clinical manifestation including high fever and gastrointestinal symptoms. These symptoms were also expressed among Blastocystis sp. infected individuals, a parasite commonly seen in human stools. This parasite has been previously reported to replicate faster upon exposure to high temperature. The present study is a hospitalized-based cross-sectional study involved the collection of faecal sample from dengue patients. Stool examination was done by in vitro cultivation to isolate Blastocystis sp. Growth pattern of all the positive isolates were analyzed to identify the multiplication rate of Blastocystis sp. isolated from dengue patients. Distribution of Blastocystis sp. among dengue patients was 23.6%. Dengue patients who were positive for Blastocystis sp. infection denoted a significantly higher fever rate reaching 38.73°C (p<0.05) compared to the non-Blastocystis sp. infected patients (38.44°C). It was also found that Blastocystis sp. infected patients complained of frequenting the toilet more than five times a day (p<0.05) compared to those who were non-Blastocystis sp. infected. At the same time, the duration of hospitalization was significantly longer (p<0.05) for Blastocystis sp. infected dengue patients compared to the non-Blastocystis sp. infected patients. Besides, Blastocystis sp. isolated from dengue patients (in vivo thermal stress) showed a higher growth rate compared to the non-dengue isolated which was exposed to high temperature (in vitro thermal stress). Our findings suggest that presence of Blastocystis sp. during dengue infection could trigger the increase of temperature which could be due to highly elevated pro inflammatory cytokines by both parasitic and virus infection. This could justify why the temperature in Blastocystis sp. infected dengue patients is higher compared to the non-Blastocystis sp. infected patients. Higher temperature could have triggered a greater parasite multiplication rate that contributed to the aggravation of the gastrointestinal symptoms.
    Matched MeSH terms: Health Care Costs
  14. Fulltext Understanding the Financial Needs Following Diagnosis of Breast Cancer in a Setting with Universal Health Coverage
    Kong YC, Wong LP, Ng CW, Taib NA, Bhoo-Pathy NT, Yusof MM, et al.
    Oncologist, 2020 06;25(6):497-504.
    PMID: 31922332 DOI: 10.1634/theoncologist.2019-0426
    BACKGROUND: A diagnosis of cancer negatively impacts the financial wellbeing of affected individuals as well as their households. We aimed to gain an in-depth understanding of the financial needs following diagnosis of breast cancer in a middle-income setting with universal health coverage.

    MATERIALS AND METHODS: Twelve focus group discussions (n = 64) were conducted with women with breast cancer from two public and three private hospitals. This study specifically focused on (a) health costs, (b) nonhealth costs, (c) employment and earnings, and (d) financial assistance. Thematic analysis was used.

    RESULTS: Financial needs related to cancer treatment and health care varied according to the participant's socioeconomic background and type of medical insurance. Although having medical insurance alleviated cancer treatment-related financial difficulties, limited policy coverage for cancer care and suboptimal reimbursement policies were common complaints. Nonhealth expenditures were also cited as an important source of financial distress; patients from low-income households reported transport and parking costs as troublesome, with some struggling to afford basic necessities, whereas participants from higher-income households mentioned hired help, special food and/or supplements and appliances as expensive needs following cancer. Needy patients had a hard time navigating through the complex system to obtain financial support. Irrespective of socioeconomic status, reductions in household income due to loss of employment and/or earnings were a major source of economic hardship.

    CONCLUSION: There are many unmet financial needs following a diagnosis of (breast) cancer even in settings with universal health coverage. Health care professionals may only be able to fulfill these unmet needs through multisectoral collaborations, catalyzed by strong political will.

    IMPLICATIONS FOR PRACTICE: As unmet financial needs exist among patients with cancer across all socioeconomic groups, including for patients with medical insurance, financial navigation should be prioritized as an important component of cancer survivorship services, including in the low- and middle-income settings. Apart from assisting survivors to understand the costs of cancer care, navigate the complex system to obtain financial assistance, or file health insurance claims, any planned patient navigation program should also provide support to deal with employment-related challenges and navigate return to work. It is also echoed that costs for essential personal items (e.g., breast prostheses) should be covered by health insurance or subsidized by the government.

    Matched MeSH terms: Health Care Costs
  15. Fulltext Strengthening Primary Health-Care Services to Help Prevent and Control Long-Term (Chronic) Non-Communicable Diseases in Low- and Middle-Income Countries
    Haque M, Islam T, Rahman NAA, McKimm J, Abdullah A, Dhingra S
    Risk Manag Healthc Policy, 2020;13:409-426.
    PMID: 32547272 DOI: 10.2147/RMHP.S239074
    The prevalence of long-term (chronic) non-communicable diseases (NCDs) is increasing globally due to an ageing global population, urbanization, changes in lifestyles, and inequitable access to healthcare. Although previously more common in high- and upper-middle-income countries, lower-middle-income countries (LMICs) are more affected, with NCDs in LMICs currently accounting for 85-90% of premature deaths among 30-69 years old. NCDs have both high morbidity and mortality and high treatment costs, not only for the diseases themselves but also for their complications. Primary health care (PHC) services are a vital component in the prevention and control of long-term NCDs, particularly in LMICs, where the health infrastructure and hospital services may be under strain. Drawing from published studies, this review analyses how PHC services can be utilized and strengthened to help prevent and control long-term NCDs in LMICs. The review finds that a PHC service approach, which deals with health in a comprehensive way, including the promotion, prevention, and control of diseases, can be useful in both high and low resource settings. Further, a PHC based approach also provides opportunities for communities to better access appropriate healthcare, which ensures more significant equity, efficiency, effectiveness, safety, and timeliness, empowers service users, and helps healthcare providers to achieve better health outcomes at lower costs.
    Matched MeSH terms: Health Care Costs
  16. Chinese medicine in Malaysia and Singapore: the business of healing
    Ooi GL
    Am J Chin Med, 1993;21(3-4):197-212.
    PMID: 8135163 DOI: 10.1142/S0192415X93000236
    Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical practice in Malaysia and Singapore with the aim of understanding their implications for the persistence of this medical tradition.
    Matched MeSH terms: Health Care Costs
  17. Fulltext Impact on parents during hospitalisation for acute diarrhoea in young children
    Lee WS, Chai PF, Ismail Z
    Singapore Med J, 2012 Nov;53(11):755-9.
    PMID: 23192504
    This study aimed to determine the emotional impact on parents of young children who require hospitalisation for acute diarrhoea (AD), and the disruption of daily activities experienced and costs incurred by them.
    Matched MeSH terms: Health Care Costs
  18. Fulltext Self care interventions for sexual and reproductive health and rights: costs, benefits, and financing
    Remme M, Narasimhan M, Wilson D, Ali M, Vijayasingham L, Ghani F, et al.
    BMJ, 2019 Apr 01;365:l1228.
    PMID: 30936210 DOI: 10.1136/bmj.l1228
    Michelle Remme and colleagues argue that if costs to users are considered and their financing is right, self care interventions for sexual and reproductive health can improve equity and efficiency
    Matched MeSH terms: Health Care Costs
  19. Fulltext Approaches to refining estimates of global burden and economics of dengue
    Shepard DS, Undurraga EA, Betancourt-Cravioto M, Guzmán MG, Halstead SB, Harris E, et al.
    PLoS Negl Trop Dis, 2014 Nov;8(11):e3306.
    PMID: 25412506 DOI: 10.1371/journal.pntd.0003306
    Dengue presents a formidable and growing global economic and disease burden, with around half the world's population estimated to be at risk of infection. There is wide variation and substantial uncertainty in current estimates of dengue disease burden and, consequently, on economic burden estimates. Dengue disease varies across time, geography and persons affected. Variations in the transmission of four different viruses and interactions among vector density and host's immune status, age, pre-existing medical conditions, all contribute to the disease's complexity. This systematic review aims to identify and examine estimates of dengue disease burden and costs, discuss major sources of uncertainty, and suggest next steps to improve estimates. Economic analysis of dengue is mainly concerned with costs of illness, particularly in estimating total episodes of symptomatic dengue. However, national dengue disease reporting systems show a great diversity in design and implementation, hindering accurate global estimates of dengue episodes and country comparisons. A combination of immediate, short-, and long-term strategies could substantially improve estimates of disease and, consequently, of economic burden of dengue. Suggestions for immediate implementation include refining analysis of currently available data to adjust reported episodes and expanding data collection in empirical studies, such as documenting the number of ambulatory visits before and after hospitalization and including breakdowns by age. Short-term recommendations include merging multiple data sources, such as cohort and surveillance data to evaluate the accuracy of reporting rates (by health sector, treatment, severity, etc.), and using covariates to extrapolate dengue incidence to locations with no or limited reporting. Long-term efforts aim at strengthening capacity to document dengue transmission using serological methods to systematically analyze and relate to epidemiologic data. As promising tools for diagnosis, vaccination, vector control, and treatment are being developed, these recommended steps should improve objective, systematic measures of dengue burden to strengthen health policy decisions.
    Matched MeSH terms: Health Care Costs
  20. Cost analysis of risperidone long-acting injection in the treatment of schizophrenia and schizoaffective disorders in Hong Kong: an approach using generalised estimating equations
    Wu DB, Lee EH, Chung WS, Chow DP, Lee VW, Wong MC, et al.
    Psychiatry Res, 2013 Dec 30;210(3):745-50.
    PMID: 24012164 DOI: 10.1016/j.psychres.2013.07.012
    Schizophrenia is one of the most expensive psychiatric illnesses. This study compared retrospectively health-care resources consumed 12 months before and 24 months after risperidone long-acting injection (RLAI) treatment in Hong Kong. A mirror-image analysis was conducted using data (N=191) from three public hospitals in Hong Kong from 2003 to 2007. The main outcome measure was hospitalisation cost. Other secondary outcomes such as hospitalisation episodes, outpatient visits and adverse events were also compared. A predictive model was established using linear regression based on generalised estimating equations. Analysis showed that RLAI was associated with a reduction in hospitalisation cost by HK$10,001,390 (24.7%) (HK$40,418,694 vs. HK$30,417,303; P-value <0.05). Days of hospitalisation were reduced by 1538 days (10.1%) (15,271 vs. 13,733; P-value <0.05). The predictive model estimated that the hospitalisation cost of patients using RLAI was only 11.1% (3.1-3.93%, 95% confidence interval (CI)) compared to those receiving conventional antipsychotics combined with oral risperidone. Cost of hospitalisation was significantly reduced after RLAI therapy. However, results should be considered as indicative or suggestive only, due to potential channelling bias where certain drug regimens are preferentially prescribed to patients with particular conditions. The findings from our study may be useful in health-care decision making considering treatment options for schizophrenia in resource-limited settings.
    Matched MeSH terms: Health Care Costs/statistics & numerical data*
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