Economic Burden Of Disease Research Articles

EE674 Economic Burden of Patients With Glioblastoma in Five Key European Countries: A Systematic Review

This systematic literature review aimed to identify comprehensive evidence on the economic burden of disease among patients with glioblastoma in five key European countries (the United Kingdom [UK], France, Germany, Italy, and Spain).

OP46 Assessing The Quality Of Pharmacoeconomic Evaluations About Type 2 Diabetes Mellitus Drugs In National Reimbursement Drug List

IntroductionWith the disease spectrum changing in China, type 2 diabetes mellitus (T2DM) has become the main chronic disease which affects people’s health severely, bring patients serious economic burden of disease. For T2DM patients, reliable quality of evidence in decision-making are significant, improving the efficiency of the adjustment of the National Reimbursement Drug List (NRDL). Based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS), we aimed to evaluate the quality of all published pharmacoeconomic evaluations on T2DM drugs in 2020 NRDL.MethodsBecause the 2020 NRDL came into effect on 1 March 2021, we searched all published pharmacoeconomic evaluations about T2DM drugs in 2020 NRDL before March 2021 in China National Knowledge Infrastructure (CNKI), Wan fang Data, China Science and Technology Journal Database (VIP), PubMed, and Web of Science. According to the criterion of inclusion and exclusion, all documents were screened and then relevant basic information of targeted documents was extracted. The quality was evaluated by calculating the final scores based on CHEERS. Two reviewers assessed each publication’s quality using the CHEERS instrument and summarized study quality.ResultsA total of 910 papers were searched, and 24 papers were included. These involved six T2DM drugs, specifically IDegAsp, exenatide, liraglutide, lixisenatide, dapagliflozin and empagliflozin. The average score was 18.31, the standard deviation was 3.67, and the average scoring rate was 77.41 percent. Among all items, “characterizing heterogeneity” scored 0.04, least satisfied with requirements. “Setting and location”, “choice of health outcomes” and “assumptions” scored one, most satisfied with requirements. Among the average scores of all parts, “results” scored lowest at 0.55, and “methods” scored highest at 0.85. The Wilcoxon sum-rank tests showed that score rate which represented reporting quality of economic evaluation (EE) was significantly related to “journal type”, “EEs type”, “model choice” and “study perspective”.ConclusionsThe methodological quality of pharmacoeconomic evaluations about T2DM drugs in 2020 NRDL needs to be improved. Improving the quality of literature is the basic guarantee of scientific decision-making in national medical insurance negotiation.

Relative acquisition evaluation of health poverty alleviation project: a quantitative study of data from different regions of China

BackgroundPoverty is the greatest obstacle to the realization of human rights, among which illness is the leading cause in China. In 2015, China began to implement the health poverty alleviation project (HPAP). By 2020, all rural households living below the current poverty level (2300 yuan per person per year) have been lifted out of poverty.MethodsThis study introduces the concept of relative acquisition and constructs a scale based on the capability approach to measure the relative acquisition and compares its fairness of HPAP.ResultsThe findings show that the values of the relative acquisition of HPAP in survey areas are all reached middle level (0.4–0.6), with 0 indicating the worst level and 1 indicating the best level. Specifically, the values of the functional activities of "health care", "health ability", "equal treatment opportunities" and "social support" are all above 0.4, while the values of "economic conditions" and "health education" are below 0.4.ConclusionsThe HPAP plays a significant role in reducing the economic burden of disease on patients. However, due to insufficient social support and health education, the HPAP objects lack endogenous motivation to fight against poverty, and the fairness also needs to be improved.

Spatial effects of air pollution on the economic burden of disease: implications of health and environment crisis in a post-COVID-19 world

BackgroundAir pollution has been identified as related to the diseases of susceptible population, but the spatial heterogeneity of its economic burden and its determinants are rarely investigated. The issue is of great policy significance, especially after the epidemic of COVID-19, when human are facing the joint crisis of health and environment, and some areas is prone to falling into poverty.MethodsThe geographical detector was adopted to study the spatial distribution characteristics of the incidence of catastrophic health expenditure (ICHE) for older adults in 100 rural areas in China at the prefecture-city level. The health factors, sociological factors, policy factors and environmental factors and their interactions are identified.ResultsFirst, most health service factors had strong explanatory power for ICHE whether it interacts with air pollution. Second, 50 single-factor high-risk areas of ICHE were found in the study, but at the same time, there were 21 areas dominated by multiple factors.ConclusionThe different contributions and synergy among the factors constitute the complex mechanism of factors and catastrophic health expenditure. Moreover, during this process, air pollution aggravates the contribution of health service factors toward ICHE. In addition, the leading factors of ICHE are different among regions. At the end, this paper also puts forward some policy suggestions from the perspective of health and environment crisis in the post-COVID-19 world: environmental protection policies should be combined with the prevention of infectious diseases; advanced health investment is the most cost-effective policy for the inverse health sequences of air pollution and infectious diseases such as coronavirus disease 2019 (COVID-19); integrating environmental protection policy into healthy development policy, different regions take targeted measures to cope with the intertwined crisis.

Major economic burden of musculoskeletal and connective tissue diseases in Slovenia

Abstract Background Musculoskeletal and connective tissue diseases represent a growing public health problem, a great burden on health systems and place a heavy burden on society as a whole. Patients with musculoskeletal and connective tissue diseases often retire early, and any early retirement that could be prevented represents a loss of human capital, which means great social and economic damage to society. The present study was conducted in order to calculate for the first time in Slovenia the costs of the six most common diseases of the musculoskeletal and connective tissue diseases for the period from 2016-2018. Methods The calculated burden of musculoskeletal and connective tissue diseases was based on the calculation of various direct and indirect costs cross-sectionally at the level of one year. The methodology of National Transfer Accounts (NTA) was used for the calculation of indirect costs. Six major diagnoses based on the International Classification of Diseases and Related Health Problems for statistical purposes were selected for calculation. Data were obtained from different national routine databases. Results Calculations of the economic burden of musculoskeletal and connective tissue diseases in Slovenia showed that the economic costs of six selected diagnoses in the period 2016-2018 averaged about 5% of total health expenditure or 0.4% of gross domestic product in this period. The highest direct costs were hospitalizations, followed by costs for medicines, first curative visits at the primary level and visits to the outpatient clinic at the secondary level. Conclusions The results of the first calculation of the burden of musculoskeletal and connective tissue diseases in Slovenia showed a high economic burden of these diseases in the period from 2016 to 2018. The economic burden is underestimated and would be significantly higher considering all diagnoses from this group of diseases. Key messages

Direct Costs Attributable to Hearing Loss in China: Based on an Econometric Model.

To our knowledge, hearing loss has been proved by a few studies from developed countries to bring a high economic burden of disease, but there is no relevant cost estimate in China. The purpose of our study was to measure the direct costs attributable to hearing loss among middle-aged and older people aged 45 and above in China in 2011, 2013, and 2015. On the basis of data from the China Health and Retirement Longitudinal Study and the China Statistical Yearbook, an econometric model was used to obtain the hearing-attributable fraction, and then the direct costs attributable to hearing loss of middle-aged and older people aged 45 and above in China in 2011, 2013, and 2015 were calculated. In 2011, 2013, and 2015, the direct costs attributable to hearing loss of middle-aged and older people aged 45 and above in China were $50.699 billion, $81.783 billion, and $106.777 billion, accounting for 3.43, 4.54, and 5.54% of the overall healthcare costs in the same year, respectively. Among the direct costs attributable to hearing loss, direct outpatient costs accounted for 75.75 to 81.13%, and direct inpatient costs accounted for 18.87 to 24.25%. The direct costs attributable to hearing loss for Chinese adults aged 45 and above have placed a heavy burden on Chinese society. The government should give priority and take effective measures to the prevention and treatment of hearing loss.

MDS-447 A Systematic Literature Review of the Economic Burden in Patients With Myelodysplastic Syndromes

Patients with higher-risk myelodysplastic syndromes (HR-MDS), if left untreated, have lower overall survival and increased economic burden. This systematic literature review (SLR) identified comprehensive evidence on the economic burden of disease among patients with low-to-high-risk MDS. Literature search of English publications from 2011-2021 was conducted in Embase®, MEDLINE® and MEDLINE-In-process, including relevant conference proceedings to identify economic burden of MDS that fulfilled pre-defined inclusion criteria. Data on study characteristics, patient demographics and economic burden were extracted. A total of 20 studies fulfilled the eligibility criteria for economic burden of MDS. Overall, costs were greater among patients with high-risk versus low-risk MDS. Costs were higher in first year of diagnosis (mean [SD], $17,337 [$19,696]) versus second year (mean [SD]: $12,976 [$14,135]), with chemotherapy and supportive care being key cost drivers. Additionally, hospitalization, comorbidities, transfusions, and use of hypomethylating agents (HMAs) were main cost drivers for high-risk MDS. Transfused patients incurred significantly higher mean costs than non-transfused patients ($88,824 versus $29,519; p<0.001); transfusions alone lead to an approximately 50% increase in monthly costs. The mean (95%CI) number of transfusions over 4 years were highest for very-high-risk groups 171 (135-200) and lowest for very-low-risk groups 25 (20-32). The median (IQR) number of hospitalizations were higher in transfusion-dependent 6 (4-9) than non-transfusion-dependent patients 2 (1-4). Patients who did not persist with their HMA therapy were associated with increased total healthcare costs and resource use. Overall, costs were greater with high-risk versus low-risk MDS. Transfusion and HMAs were prominent cost drivers. HMAs are the first therapeutic choice for MDS; however, their usage is limited owing to lack of durable response. There exists an unmet need for appropriate therapies focusing on improving survival and reducing economic burden of MDS. These findings are suggestive, as majority of data was available from the US. More studies are needed from across geographies to draw more meaningful conclusions.

The Economic Burden of Disease in France From the National Health Insurance Perspective: The Healthcare Expenditures and Conditions Mapping Used to Prepare the French Social Security Funding Act and the Public Health Act.

Background:Identifying the most frequently treated and the costliest health conditions is essential for prioritizing actions to improve the resilience of health systems.Objectives:Healthcare Expenditures and Conditions Mapping describes the annual economic burden of 58 health conditions to prepare the French Social Security Funding Act and the Public Health Act.Design:Annual cross-sectional study (2015–2019) based on the French national health database.Subjects:National health insurance beneficiaries (97% of the French residents).Measures:All individual health care expenditures reimbursed by the national health insurance were attributed to 58 health conditions (treated diseases, chronic treatments, and episodes of care) identified by using algorithms based on available medical information (diagnosis coded during hospital stays, long-term diseases, and specific drugs).Results:In 2019, €167.0 billion were reimbursed to 66.3 million people (52% women, median age: 42 y). The most prevalent treated diseases were diabetes (6.0%), chronic respiratory diseases (5.5%), and coronary diseases (3.2%). Coronary diseases accounted for 4.6% of expenditures, neurotic and mood disorders 3.7%, psychotic disorders 2.8%, and breast cancer 2.1%. Between 2015 and 2019, the expenditures increased primarily for diabetes (+€906 million) and neurotic and mood disorders (+€861 million) due to the growing number of patients. “Active lung cancer” (+€797 million) represented the highest relative increase (+54%) due to expenditures for the expensive drugs and medical devices delivered at hospital.Conclusions:These results have provided policy-makers, evaluators, and public health specialists with key insights into identifying health priorities and a better understanding of trends in health care expenditures in France.

The influence of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in Chinese low-income areas

BackgroundIn recent years, due to the increasing number of cross-regional medical patients, countries around the world have issued a series of policies or regulations to reduce their out-of-pocket burden. In this context, this study intended to explore the impact of the Spatio-temporal characteristics of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in low-income areas.MethodsThis study included 54,904 data of cross-provincial medical treatment of malignant tumor patients insured in Heilongjiang Province, China in 2020. Firstly, Microsoft Excel 2019 and ArcGIS 10.2 were applied to conduct a descriptive analysis of the Spatio-temporal characteristics of their cross-provincial medical treatment. Then, binary and multivariate logistic regression models were used to explore the specific impact of economic level and geographical distance of medical regions on total medical expenses, medical insurance payments, and out-of-pocket expenses.ResultsThe number of cross-regional medical patients showed a gradual upward trend from February to December, and fell back in January. They were concentrated in regions with high economic level and short distance from the insured region, where were more likely to form the group with high out-of-pocket expenses (AOR = 3.620, P < 0.001; AOR = 1.882, P < 0.001). While this possibility in middle-distance medical regions were less (AOR = 0.545, P < 0.001). Afterwards, two sensitivity analysis methods showed that the results were robust.ConclusionThe number of cross-regional medical patients with malignant tumors in low-income areas is affected by seasonal factors, meanwhile, their total medical expenses, actual medical insurance payment levels, and out-of-pocket expenses are all affected by the economic level and geographical distance of medical regions. And the middle-distance medical regions may be the best choice for patients with planned cross-regional medical treatment. These provide some evidence for policymakers to improve the fairness and sustainability of medical security for cross-regional medical patients and reduce their direct economic burden of disease.

The Burden of Plastic Surgery Related Disease in Canada: A Perspective Based on the 2019 Global Burden of Disease Study.

Purpose: Identifying the burden of disease related to plastic and reconstructive surgery in Canada will provide timely population-based data, inform policy, and generate support for research funding. Methods and Patients: Data on the burden of disease (ie, prevalence, incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years [DALYs]), were extracted from the Global Burden of Disease 2019 results tool for all available and relevant plastic surgery diseases. The economic burden of disease in Canadian dollars was calculated based on prior studies. Data are presented as either rates (per 100 000) or counts with the associated uncertainty interval. Results: In 2019, plastic surgery related conditions in Canada had an overall age-standardized DALY rate of 556 per 100 000 [463-664]. Of these conditions, breast cancer was responsible for approximately 50% of the overall burden of disease, with an age-standardized DALY rate of 268 per 100 000 [244-294] followed by squamous cell carcinoma (66 per 100 000 [45-94]) and thermal burns (61 per 100 000 [46-82]). Age-standardized incidence rates were highest for cellulitis (2654 per 100 000 [2502-2812]). Breast cancer had the highest age-standardized cost of care of all plastic surgery related diseases, at $5.1 billion, approximately half of the total age-standardized cost of $10.6 billion for included plastic surgery diseases. Conclusion: Plastic and reconstructive surgery related diseases, particularly breast cancer, thermal burns, and malignant melanoma, are responsible for a high burden of disease and significant cost to the Canadian healthcare system. These results will help guide national healthcare policy and should provide support to directing funding and research efforts toward impactful diseases facing the Canadian healthcare system.

EE279 A Systematic Literature Review of the Economic Burden in Patients with Myelodysplastic Syndrome

Patients with higher-risk myelodysplastic syndromes (HR-MDS), if left untreated have lower overall survival and increased economic burden. This systematic literature review (SLR) identified comprehensive evidence on the economic burden of disease among patients with low-to-high risk MDS. Methodology: Literature search of English publications from 2011-2021 was conducted in Embase®, MEDLINE® and MEDLINE-In-process, including relevant conference proceedings to identify economic burden of MDS that fulfilled pre-defined inclusion criteria.

EE49 Economic Burden of Disease in Patients with Exudative Age-Related Macular Degeneration Using Common Data Model in South Korea

EE49 Economic Burden of Disease in Patients with Exudative Age-Related Macular Degeneration Using Common Data Model in South Korea

A cost-effectiveness analysis of PHiD-CV compared to PCV13 in a national immunization program setting in Tunisia

ABSTRACT Background In response to the substantial clinical and economic burden of diseases caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) in Tunisia, the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) was recently introduced into the national immunization program. However, there has yet to be a full-scale health economic analysis comparing currently available pneumococcal conjugate vaccines (PCVs) in Tunisia. Methods A Markov model that simulated the disease processes of invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) over a newborn cohort lifetime was used to evaluate the cost-effectiveness/utility of PHiD-CV and the 13-valent pneumococcal conjugate vaccine (PCV13) from payer’s perspective, using 3% discounting. Vaccine effects were considered for up to 9 years of age. Results Vaccination with PHiD-CV or PCV13 was estimated to avert approximately 700 cases of IPD (200 meningitis, 500 bacteremia), and around 5,000 cases of all-cause pneumonia. However, PHiD-CV vaccination was estimated to avert around 4,000 additional AOM cases (18,000) versus PCV13 (14,000). Both PCVs were demonstrated to be cost-effective interventions, but PHiD-CV was estimated to generate additional cost savings of almost $1 million US dollars (USD) with similar levels of clinical benefits. An additional scenario which incorporated serotype-specific vaccine efficacy found no significant change in overall results. Conclusion PCVs are a cost-effective strategy to relieve the burden associated with diseases caused by S. pneumoniae and NTHi in Tunisia. PHiD-CV is more cost-effective than PCV13, generating similar health benefits, at a reduced net cost of almost $1 million USD per vaccinated cohort.

Economic Burden and Influencing Factors of Acute Gastroenteritis in China: A Population-Based Face to Face Survey in 2018.

BackgroundAcute gastroenteritis is an important and highly prevalent public health problem worldwide. The purpose of this study was to assess the economic burden of disease and its influencing factors in patients with acute gastroenteritis in Heilongjiang Province, China.MethodsA multi-stage stratified random sampling method was used in a face-to-face household survey in 2018. Demographic and socioeconomic characteristics, clinical symptoms, suspicious dietary history, and disease treatment information were collected from 19,647 respondents. One-way analysis of variance and multiple stepwise regression analysis were used to investigate the factors associated with the economic burden of acute gastroenteritis. Quantitative risk analysis and sensitivity analysis were performed to estimate the uncertainty and risk factors of the economic burden of acute gastroenteritis.ResultsThe total economic burden of patients with acute gastroenteritis was 63,969.22 CNY (Chinese Yuan), of which the direct economic burden accounted for 63.82%; the per capita economic burden was 131.35 CNY per month. Age, region, disease duration, and disease treatment were the main factors significantly associated with the economic burden of acute gastroenteritis (P < 0.05). The average economic burden of patients with acute gastroenteritis was approximately 571.84 CNY/person (95% CI: 227–1,459). Sensitivity analysis showed that the greatest impact was from the indirect economic burden.ConclusionsAcute gastroenteritis brings a substantial health burden to patients due to its high incidence. The economic burden of self-purchased drugs and the indirect economic burden of patients cannot be ignored. To better estimate the economic burden of acute gastroenteritis in China, further studies on the pathogen-specific economic burden of acute gastroenteritis are required.

Components of Out-of-Pocket Expenditure and Their Relative Contribution to Economic Burden of Diseases in India

High out-of-pocket expenditure (OOPE) on health in India may limit achieving universal health coverage. A clear insight on the components of health expenditure may be necessary to make allocative decisions to reduce OOPE, and such details by sociodemographic group and state have not been studied in India. To analyze the relative contribution of drugs, diagnostic tests, doctor and surgeon fees, and expenditure on other medical services and nonmedical health-related services, such as transport, lodging, and food, by sociodemographic characteristics of patients, geography, and type of illness. A population-based cross-sectional health consumption survey conducted by the National Sample Survey Organisation in 2018 was analyzed in this cross-sectional study. Respondents who provided complete information on costs of medicine, doctors, diagnostics tests, other medical costs, and nonmedical costs were selected. Data were analyzed from August through September 2021. Mean and median share of components (ie, medicine, diagnostic tests, doctor fees, other medical costs, and nonmedical costs) in total health care expenditure and income were calculated. Bivariate survey-weighted mean (with 95% CI) and median (IQR) expenditures were calculated for each component across sociodemographic characteristics. The proportion of total expenditure and income contributed by each cost was calculated for each individual. Mean and median were then used to summarize such proportions at the population level. The association between state net domestic product per capita and component share of each health care service was graphically explored. Health expenditure details were analyzed for 43 781 individuals for inpatient costs (27 272 [64.3%] women; 26 830 individuals aged 25-64 years [59.9%]) and 8914 individuals for outpatient costs (4176 [48.2%] women; 4901 individuals aged 25-64 years [54.2%]); most individuals were rural residents (24 106 inpatients [67.0]; 4591 outpatients [63.9%]). Medicines accounted for a mean of 29.1% (95% CI, 28.9%-29.2%) of OOPE among inpatients and 60.3% (95% CI, 59.7%-60.9%) of OOPE among outpatients. Doctor consultation charges were a mean of 15.3% (95% CI, 15.1%-15.4%) of OOPE among inpatients and 12.4% (95% CI, 12.1%-12.6%) of OOPE among outpatients. Diagnostic tests accounted for a mean of 12.3% (95% CI, 12.2%-12.4%) of OOPE for inpatient and 9.2% (95% CI, 8.9%-9.5%) of OOPE for outpatient services. Nonmedical costs accounted for a mean of 23.6% (95% CI, 23.3%-23.8%) of OOPE among inpatients and 14.6% (95% CI, 14.1%-15.1%) of OOPE among outpatients. Mean share of OOPE from doctor consultations and diagnostic test charges increased with socioeconomic status. For example, for the lowest vs highest monthly per capita income quintile among inpatients, doctor consultations accounted for 11.5% (95% CI, 11.1%-11.8%) vs 21.2% (95% CI, 20.8%-21.6%), and diagnostic test charges accounted for 10.9% (95% CI, 10.6%-11.1%) vs 14.3% (95% CI, 14.0%-14.5%). The proportion of mean annual health expenditure from mean annual income was $299 of $1918 (15.6%) for inpatient and $391 of $1788 (21.9%) for outpatient services. This study found that nonmedical costs were significant, share of total health care OOPE from doctor consultation and diagnostic test charges increased with socioeconomic status, and annual cost as a proportion of annual income was lower for inpatient than outpatient services.

Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study.

BackgroundGeneralized pustular psoriasis (GPP), which can occur with or without psoriasis vulgaris (PV), is a severe form of pustular psoriasis with potentially life-threatening symptoms. GPP is also associated with several comorbidities, which further adds to the burden of disease. This study investigates the economic burden of disease in patients with GPP.MethodsAll-cause and GPP-specific healthcare resource use (inpatient stays, physician visits and drug use), as well as associated costs, were compared for year 2015 between GPP patients (n = 914) and two matched control groups representing the general population (n = 4047) and patients with PV but no GPP (n = 2556). Information on resource use for 2015 was obtained from the Swedish National Patient Register and Swedish Prescribed Drug Register, respectively.ResultsAll-cause inpatient stays, physician visits, and use of psoriasis-related drugs were significantly more common among GPP patients compared to both control groups. This difference was reflected in total direct cost for GPP patients (5062 euros/year) which was 3.1 and 1.8 times higher (p < 0.001) compared to the general population and PV controls, respectively. For GPP patients, the share of total cost was 22% for all-cause physician outpatient visits and 40% for all-cause inpatient stays. However, only 6.3% and 11.3% of these costs, respectively, were due to GPP-specific problems. Psoriasis-related drugs constituted 27% of total costs for GPP patients of which a large fraction (86%) was represented by biologics.ConclusionThis study demonstrates a higher economic burden for GPP patients compared to both the general population and patients with PV, with inpatient visits and use of biologic drugs as major cost driving factors. Only fractions of the costs for physician visits and inpatient stays were attributable to specific GPP problems, indicating a higher economic burden of GPP-consequences and complications.

Profile of Non-Melanoma Skin Cancer and Malignant Melanoma at Dr. Mohammad Hoesin General Hospital Palembang from 2017 - 2019: A Retrospective Study

Background: Currently, there is an increasing trend in skin cancer incidence, especially non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), also malignant melanoma (MM), causing an increase in morbidity and mortality rates. The high treatment cost causes an economic burden of disease in the country and negatively impacts public health issues. This study aimed to determine the profile of NMSC and MM regarding the sex, age, occupation, location of the lesion, clinicohistopathological diagnosis of skin cancer in Dr. Mohammad Hoesin General Hospital Palembang January 2017-December 2019.&#x0D; Methods: A retrospective analytical observational study obtained from medical records of NMSC and MM patients in Dr. Mohammad Hoesin General Hospital Palembang from January 2017-December 2019 as confirmed using histopathological results from the Pathology Department.&#x0D; Results: There were 324 new cases of NMSC and MM, including BCC 162 cases (50%) and SCC 130 cases (40.1%), whereas MM 32 cases (9.9%). Women had a higher probability of developing skin cancer with a ratio of 1.13:1. The average age of skin cancer was between 55-64 years old (33.6%), with a mean age of 57 years old. There was a statistically significant relationship between gender, age, occupation, and areas of skin cancer against skin cancer. Furthermore, overexposure to ultraviolet (UV) radiation is related to high-risk occupations, including farmers (50%), while the most frequent location of skin cancer was the face (67.3%).&#x0D; Conclusion: Our study implicated a 1.5-fold increase in new cases of skin cancer between 2017 to 2019. BCC cases were more prevalent than SCC and MM cases. There was also a significant association between skin cancer and occupation also the location of skin cancer as the risk factor for UV exposure. Nevertheless, further research involving larger samples or a multicenter approach is needed.

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

BackgroundIn recent years, the goal of universal coverage of the basic medical insurance schemes has been basically achieved in China, but the heavy economic burden of diseases is still the main cause of poverty in many households. Exploring catastrophic health expenditure (CHE) and its inequality are highly important for forward-looking policymaking. This study aims to compare the incidence, intensity and inequality of CHE between urban and rural households in China.MethodsThis study was based on a national representative household survey—the China Family Panel Studies (CFPS)—that was conducted from 2012 to 2018. Concentration index (CI) was employed to measure the inequality of CHE incidence and overshoot, while the decomposition method of the CI was used to estimate the main influencing factors affecting inequality of CHE incidence.ResultsFrom 2012 to 2018, the CHE incidence of urban households increased from 11.01 to 11.88%, while the CHE incidence of rural households decreased from 18.42 to 18.31%. During the same period, the CI of CHE incidence for urban households decreased from − 0.1480 to − 0.1693, while that for rural households declined from − 0.1062 to − 0.1501. The major contribution to the pro-poor inequality in CHE incidence was associated with socioeconomic status, lagged CHE, receiving inpatient services, having elderly members, education of household head, and self-assessed health status of household head.ConclusionsRural households had higher risk of incurring CHE than urban households. The strong pro-poor inequality for CHE incidence and overshoot could be found in both two groups. The problem of poverty due to illness was more severe among low-income groups in rural areas than in urban areas. The relevant policy interventions should further focus on encouraging the development of supplementary medical insurance and increasing the reimbursement rate for hospitalization expenses in the medical assistance system.

Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province.

China has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008–2018) data from Jiangsu province. Ordinary least squares and binary multivariate logistic regression of pooled cross-sectional data were carried out to evaluate the effect of universal health insurance coverage and other socioeconomic factors on the economic burden of disease. Total health expenses (THE) first increased and then decreased during the survey period while out-of-pocket health expenses (OOP) decreased except for urban residents, for whom OOP increased after 2013. Household catastrophic health expenditure (HCHE) was stable between 2008 and 2013 but increased after 2013. Social health insurance had a significant positive effect on the annual THE and OOP and a negative effect on HCHE, however, universal health insurance coverage could alleviated THE and the economic burden of disease on individuals (OOP) while it was insufficient to protect against the economic risk of diseases (HCHE), with greater benefits for urban as compared to rural residents. Other socioeconomic factors including age, marital status, education, income, and health status also influenced the economic burden of disease.

Measuring Trends in the Socioeconomic Burden of Disease in Korea, 2007-2015.

This study estimated the direct and indirect socioeconomic costs of 238 diseases and 22 injuries from a social perspective in Korea from 2007 to 2015. The socioeconomic cost of each disease group was calculated based on the Korean Standard Disease Classification System. Direct costs were estimated using health insurance claims data provided by the National Health Insurance Service. The numbers of outpatients and inpatients with the main diagnostic codes for each disease were selected as a proxy indicator for estimating patients’ medical use behavior by disease. The economic burden of disease from 2007 to 2015 showed an approximately 20% increase in total costs. From 2007 to 2015, communicable diseases (including infectious, maternal, pediatric, and nutritional diseases) accounted for 8.9-12.2% of the socioeconomic burden, while non-infectious diseases accounted for 65.7-70.7% and injuries accounted for 19.1-22.8%. The top 5 diseases in terms of the socioeconomic burden were self-harm (which took the top spot for 8 years), followed by cirrhosis of the liver, liver cancer, ischemic heart disease, and upper respiratory infections in 2007. Since 2010, the economic burden of conditions such as low back pain, falls, and acute bronchitis has been included in this ranking. This study expanded the scope of calculating the burden of disease at the national level by calculating the burden of disease in Koreans by gender and disease. These findings can be used as indicators of health equality and as useful data for establishing community-centered (or customized) health promotion policies, projects, and national health policy goals.