Economic Costs Of Illness Research Articles

Hardship financing, productivity loss, and the economic cost of illness and injury in Cambodia

BackgroundFinancial risk protection is a core dimension of universal health coverage. Hardship financing, defined as borrowing and selling land or assets to pay for healthcare, is a measure of last recourse. Increasing indebtedness and high interest rates, particularly among unregulated money lenders, can lead to a vicious cycle of poverty and exacerbate inequity.MethodsTo inform efforts to improve Cambodia’s social health protection system we analyze 2019–2020 Cambodia Socio-economic Survey data to assess hardship financing, illness and injury related productivity loss, and estimate related economic impacts. We apply two-stage Instrumental Variable multiple regression to address endogeneity relating to net income. In addition, we calculate a direct economic measure to facilitate the regular monitoring and reporting on the devastating burden of excessive out-of-pocket expenditure for policy makers.ResultsMore than 98,500 households or 2.7% of the total population resorted to hardship financing over the past year. Factors significantly increasing risk are higher out-of-pocket healthcare expenditures, illness or injury related productivity loss, and spending of savings. The economic burden from annual lost productivity from illness or injury amounts to US$ 459.9 million or 1.7% of GDP. The estimated household economic cost related to hardship financing is US$ 250.8 million or 0.9% of GDP.ConclusionsSuch losses can be mitigated with policy measures such as linking a catastrophic health coverage mechanism to the Health Equity Funds, capping interest rates on health-related loans, and using loan guarantees to incentivize microfinance institutions and banks to refinance health-related, high-interest loans from money lenders. These measures could strengthen social health protection by enhancing financial risk protection, mitigating vulnerability to the devastating economic effects of health shocks, and reducing inequities.

EFFECTS OF ILL-HEALTH COST ON MULTIDIMENSIONAL POVERTY: EVIDENCE FROM RURAL HOUSEHOLDS IN NIGERIA

Good health affects productivity and income of the workers and this will further deepen the incidence of poverty and ill-health. This study examined the linkage between ill-health cost and multidimensional poverty of rural households in Ogun state, Nigeria. Multistage sampling was used to select 240 households for the study. Data collected were analysed with descriptive statistics, economic cost of illness, multidimensional poverty index and logistic regression model. The result revealed that majority (95%) of the households experienced malaria infestation, time cost of illness contributed most (92.6%) to the total economic cost. Result revealed that 69% of households are multidimensionally poor. Furthermore, marital status (p<0.01), off-farm income (p<0.01), financial cost (p<0.01), days forgone production (p<0.1), time cost (p<0.01) and area cultivated (p<0.1) positively, and significantly influence multidimensional poverty status while household size (p<0.01), cooperative membership (p<0.05), public health care services (p<0.1) and health extension contact (p<0.01) have negative, and significant effect. The study concluded that increase in out of pocket expenditure as a result of ill-health cost increases poverty status, availability and access to public health facilities reduces poverty status, it was therefore recommended that public health facilities should be located nearer to the people with minimum social stratification that might discourage poor masses from its usage, essential drugs should be provided at subsidized rates as this will go a long way in reducing financial cost thereby reducing poverty status.

Household Strategies to Cope with the Economic Cost of Illness in Low and Middle Income Countries: A Review Study

Present study reviews the findings of various studies on coping strategies and distress financing of health care expenditure worldwide. More emphasis has been given to studies conducted in low and middle-income countries on households coping strategies but the relevant articles proceeded in high income countries on the same have also been considered. The main purpose of this review study is to recognize and examine the structure of coping strategies and distress financing used by households to pay health care expenditure and to encounter the prospective economic shocks from ill health in these countries. Findings analytically carried out from several studies show that wealthy households mainly use income and savings as a coping strategy for health care financing in low and middle-income countries. Whereas borrowings, sale of assets, contributions from relatives and other significant non-financial strategies such as intra-family labour reallocation, hiring and free community labour etc. have been found frequently used by poor households. Evidences from the studies conducted in India have also signified that along with savings/income, distress financing is playing a dominant role to cope up with financing health care in the country.

THE REPRODUCTION OF POVERTY AND POOR HEALTH IN THE PRODUCTION OF HEALTH DISPARITIES IN SOUTHERN PERU

It is a common starting assumption for analyses of health disparities that poverty and poor health occur together and mutually influence one another. While earlier research tended to focus on how poverty leads to poor health, over the past two decades it has become more common to focus on the social and economic costs of illness and disease. Yet, the majority of this research has not employed an ethnographic lens and is limited in accounting for local level factors that shape vulnerability and resilience to illness and its impact on lives and livelihoods. This paper illustrates how the inequality and health dialectic plays out among rural producers in the district of Nuñoa in the southern Peruvian Andes. Using a critical biocultural approach attending to global–local interactions, relations of power and human agency, and that is grounded in ethnographic realities, we explore connections between vulnerability and resiliency in the reproduction of poverty and poor health. While the direct costs of healthcare can be catastrophic to a household's economy in extreme cases, indirect costs to labor power and household production create for many a greater cumulative loss that limits resilience in the face of future illness and other problems. The way illness impacts lives and livelihoods in the reproduction of poverty and poor health is shaped by people's access to land, labor power, and cash reserves, so that these effects are experienced unevenly and with different long‐term implications among vulnerable populations.

Metabolic biomarkers for predicting cardiovascular disease

Cardiac and peripheral vascular biomarkers are increasingly becoming targets of both research and clinical practice. As of 2008, cardiovascular-related medical care accounts for greater than 20% of all the economic costs of illness in the United States. In the age of burgeoning financial pressures on the entire health care system, never has it been more important to try to understand who is at risk for cardiovascular disease in order to prevent new events. In this paper, we will discuss the cost of cardiovascular disease to society, clarify the definition of and need for biomarkers, offer an example of a current biomarker, namely high-sensitivity C-reactive protein, and finally examine the approval process for utilizing these in clinical practice.

The ban on opium production across Nangarhar: a risk too far?

Risk is a reality that has to be managed by households in rural Afghanistan. Some communities are more likely than others to experience risks and at the same time are the least likely to adapt and recover from the adverse outcomes when they arise. In rural Nangarhar many of the communities most likely to experience natural risks, as well as risks resulting from human activity, are also those who have been the most reliant on opium production. The impact of a comprehensive opium ban across the province for the third consecutive year has hit those communities who are most vulnerable to repeated and concurrent risks the hardest. Where these risks are compounded by the economic costs of illness, injury or death, or other life events such as marriage, households are left increasingly destitute, creating the conditions that foster further economic and political instability.

Disability indices, the economic costs of illness, and social insurance: the case of multiple sclerosis.

Debilitating, long-term illness can impose a significant economic hardship on families affected with the illness and on the wider society as well. In addition to medical research to find a cure or a prevention for such illnesses, society may wish, in the interim, to allocate resources to compensate the families burdened by the illness for the economic losses they have suffered. Such compensation will take the form of a social insurance program. The socially optimal insurance program requires two crucial pieces of information: (i) an index of physical disability and (ii) an accurate assessment of the economic losses associated with each stage of disability as measured by that index. This paper reports on an initial attempt using U.S. data to provide these two important facts for one long-term, disabling illness: multiple sclerosis.

Economic Costs of Serious Illness in Rural Southwest China: Household Coping Strategies and Health Policy Implications

Today, some 10 million Chinese peasants fall below China's official poverty line annually because of illness. Currently, more than 80 percent of China's rural residents do not have any health insurance, and most of those who do still have to pay up to 90 percent of their medical costs. Despite the grave situation, very little is known about the strategies rural Chinese utilize to cope with the economic costs of illness. In this paper, I examine how households in a rural village in Southwest China contend with economic impacts of serious illness, and I discuss how development agencies can help to alleviate the situation. I first describe the study site and my research methods. Next, drawing on qualitative and quantitative data, I analyze 10 strategies rural households use to cope with the economic costs of serious illness. In the last section, I discuss the implications of this case study for health policy makers and development agencies in China and elsewhere in the developing world.

Household strategies to cope with the economic costs of illness

The authors examine the strategies rural households in Burkina Faso used to cope with the costs of illness in order to avert negative effects for household production and assets. They use information from 51 qualitative interviews, a household time allocation study and a household survey. Both surveys use the same sample of n = 566 households. The authors analyze these strategies along four dimensions: the type of behavior, the sequence in which strategies employed, the level at which strategies are negotiated, i.e. the household level, the non-household extended kin level or the community level, and finally the success of strategies in protecting household production and assets. A taxonomy of 11 distinct types of coping behavior is developed which have the effect of either avoiding costs by ‘ignoring’ disease, or of minimizing the impact of costs on the household once illness is perceived. Intra-household labor substitution was the main strategy to compensate for any labor lost to illness. However, labor substitution did not eliminate production losses in the majority of households struck with severe illness of a productive member. Only wealthy household were able to fully compensate labor losses by hiring labor or by investing in equipment to enhance productivity. Sales of livestock was the main strategy to cope with the financial costs of health care. None of the households studied fell into calamity. However, the households' ability to avert the loss of production and/or assets was very varied and depended on household size, composition and assets, on the type and duration of illness and on clustering of crises (e.g. several repetitive or simultaneous illnesses or concurrent seasonal stress). Coping with the costs of illness largely occurred at the level of the household. Inter-household transfers of resources played only a small role. The authors develop the concept of risk households and suggest several policies with the potential to strengthen the ability of households to cope with the economic costs of illness.