Prevention Expenditures Research Articles

Optimal preventive maintenance: Balancing reliability and costs in the electricity market

This study addresses the challenge of achieving optimal preventive maintenance within power systems, aiming to balance reliability and costs effectively. The primary focus is on understanding the relationship between preventive maintenance expenditures and the failure rate of essential transmission components, particularly transformers in substations. We contribute to the existing literature by providing two key insights. Firstly, we establish a theoretical framework for determining the optimal level of preventive maintenance, which can be extended across various electricity facilities. By analyzing the relationship between preventive maintenance costs and failure rates, our goal is to identify the investment level that ensures a reliable power system while minimizing financial burdens. Secondly, we explore the functional form that accurately characterizes the link between preventive maintenance costs and failure rates. The diminishing marginal rate of failure, dependent on different functional forms, highlights the variability of optimal preventive maintenance expenses. Utilizing Lasso regression, we identify the functional form that optimally characterizes the relationship between outage occurrences and maintenance costs. These insights extend well beyond the confines of the Korean power industry, offering a sustainable approach to managing transmission facilities and enhancing the overall stability and efficiency of global electricity networks.

Trends and prescribing patterns of antimigraine medicines in nine major cities in China from 2018 to 2022: a retrospective prescription analysis

BackgroundThe objective of this study was to investigate the trends and prescribing patterns of antimigraine medicines in China.MethodsThe prescription data of outpatients diagnosed with migraine between 2018 and 2022 were extracted from the Hospital Prescription Analysis Cooperative Project of China. The demographic characteristics of migraine patients, prescription trends, and corresponding expenditures on antimigraine medicines were analyzed. We also investigated prescribing patterns of combination therapy and medicine overuse.ResultsA total of 32,246 outpatients who were diagnosed with migraine at 103 hospitals were included in this study. There were no significant trend changes in total outpatient visits, migraine prescriptions, or corresponding expenditures during the study period. Of the patients who were prescribed therapeutic medicines, 70.23% received analgesics, and 26.41% received migraine-specific agents. Nonsteroidal anti-inflammatory drugs (NSAIDs; 28.03%), caffeine-containing agents (22.15%), and opioids (16.00%) were the most commonly prescribed analgesics, with corresponding cost proportions of 11.35%, 4.08%, and 19.61%, respectively. Oral triptans (26.12%) were the most commonly prescribed migraine-specific agents and accounted for 62.21% of the total therapeutic expenditures. The proportion of patients receiving analgesic prescriptions increased from 65.25% in 2018 to 75.68% in 2022, and the proportion of patients receiving concomitant triptans decreased from 29.54% in 2018 to 21.55% in 2022 (both P < 0.001). The most frequently prescribed preventive medication classes were calcium channel blockers (CCBs; 51.59%), followed by antidepressants (20.59%) and anticonvulsants (15.82%), which accounted for 21.90%, 34.18%, and 24.15%, respectively, of the total preventive expenditures. Flunarizine (51.41%) was the most commonly prescribed preventive drug. Flupentixol/melitracen (7.53%) was the most commonly prescribed antidepressant. The most commonly prescribed anticonvulsant was topiramate (9.33%), which increased from 6.26% to 12.75% (both P < 0.001). A total of 3.88% of the patients received combined therapy for acute migraine treatment, and 18.63% received combined therapy for prevention. The prescriptions for 69.21% of opioids, 38.53% of caffeine-containing agents, 26.61% of NSAIDs, 13.97% of acetaminophen, and 6.03% of triptans were considered written medicine overuse.ConclusionsMigraine treatment gradually converges toward evidence-based and guideline-recommended treatment. Attention should be given to opioid prescribing, weak evidence-based antidepressant use, and medication overuse in migraine treatment.

The relationship between preventive dental care and overall medical expenditures.

To examine the relationship between preventive dental visits (PDVs) and medical expenditures while mitigating bias from unobserved confounding factors. Retrospective data analysis of Indiana Medicaid enrollment and claims data (2015-2018) and the Area Health Resources Files. An instrumental variable (IV) approach was used to estimate the relationship between PDVs and medical and pharmacy expenditures among Medicaid enrollees. The instrument was defined as the number of adult enrollees with at least 1 nonpreventive dental claim per total Medicaid enrollees within a Census tract per year. In naive analyses, enrollees had on average greater medical expenditures if they had a prior-year PDV (β = $397.21; 95% CI, $184.23-$610.18) and a PDV in the same year as expenditures were measured (β = $344.81; 95% CI, $193.06-$496.56). No significant differences in pharmacy expenditures were observed in naive analyses. Using the IV approach, point estimates of overall medical expenditures for the marginal enrollee who had a prior-year PDV (β = $325.17; 95% CI, -$708.03 to $1358.37) or same-year PDV (β = $170.31; 95% CI, -$598.89 to $939.52) were similar to naive results, although not significant. Our IV approach indicated that PDV was not endogenous insomespecifications. This is the first study to present estimates with causal inference from a quasi-experimental study of the effect of PDVs on overall medical expenditures. We observed that prior- or same-year PDVs were not related to overall medical or pharmacy expenditures.

The economic and environmental effects of China's environmental expenditure under financing constraints.

Sound ecological and environmental governance systems are critical for promoting green and low-carbon economic transformation and high-quality development. However, financing constraints are major obstacle to the revitalization and transformation of China's real economy. In this study, we constructed an environmental dynamic stochastic general equilibrium (E-DSGE) model that incorporates two types of environmental expenditure and financing constraints, and discussed their economic and environmental effects. Based on this, we further considered the impacts of financing constraints on policy effects. Firstly, we found that increases in carbon emission reduction subsidies in government expenditure (1) increase total economic output and (2) motivate enterprises to increase emission reduction efforts and reduce pollution intensity and emissions, thereby reducing the inventory of environmental pollutants while balancing economic benefits and emission reduction. Secondly, increasing the proportion of government special expenditure on environmental protection promote output growth and directly reduces the pollution stock in the environment. However, such policies may also reduce the emission reduction efforts of enterprises, leading to increases in their pollution emissions and intensity. Lastly, the existence of financing constraints is not conducive to the growth of total output but increases the pollution control effect of emission reduction subsidies and pollution prevention expenditure. Application of the E-DSGE model offers new theoretical insight into environmental economics and macroeconomics. Moreover, the results of this study provide a reference for optimizing the structure of fiscal expenditure.

Economic costs related to foodborne disease in Burkina Faso and Ethiopia in 2017

IntroductionFoodborne diseases (FBD) are a significant problem in low- and middle-income countries, especially in Africa. Country-specific estimates of the economic costs related to FBD caused by different hazards in different food products can inform decision makers about this problem’s magnitude. This aids policy makers in prioritising actions to mitigate risks and prevent illness. Although estimates exist for many high-income countries, they are lacking for African countries.MethodsThis study estimates economic cost in Burkina Faso and Ethiopia related to FBD caused by non-typhoidal Salmonella enterica (NTS), Campylobacter spp. (CAMP) and enterotoxigenic Escherichia coli (ETEC) in all foods, chicken meat and tomatoes. The World Health Organization’s estimates of FBD burden, updated from 2010 to 2017, were used as a basis. Economic cost estimates were the sum of estimates of willingness-to-pay (WTP) to reduce risk of death and of pain and suffering, and lost productivity. WTP was based on value of statistical life (VSL) and value of statistical life year (VSLY), extrapolated from USA data. We used sensitivity options to account for uncertainty in these values.ResultsMean economic costs related to FBD caused by NTS, CAMP and ETEC in 2017 were estimated at 391 million constant 2017 international dollars in Burkina Faso and 723 million in Ethiopia. These represent 3.0% of gross national income in Burkina Faso and 0.9% in Ethiopia. Lost productivity contributed 70%, WTP to reduce risk of death 30%, and WTP to reduce risk of pain and suffering 1-2%. NTS caused the highest costs, followed by ETEC and CAMP. Chicken meat caused 9-12 times higher costs than tomatoes. Children under five years (14.6-17.1% of populations) bore 20-75% of the costs. Due to uncertainty in disease burden and economic data, costs could be four times higher than mean estimates.DiscussionPolicies to control FBD likely result in substantial benefits, especially efforts aiming at this study’s hazards in chicken meat and children under 5 years. Efforts to reduce uncertainty in VSL, VSLY and disease burden estimates, estimate costs for other countries, attribute costs to other food products and hazards, further standardise estimation methodologies, and estimate treatment costs and illness prevention expenditures are recommended.

Research on the Impact of Health Fiscal Expenditure on Relative Poverty in Rural China

Health fiscal expenditure plays an important role in adjusting the price of medical services and reducing the medical burden of residents. If we only expand the overall scale of health fiscal expenditure and ignore the structural problems of health fiscal expenditure, it will increase the medical burden of rural residents and make them face the risk of falling into relative poverty. Based on the China General Social Survey data in 2015, 2018 and 2021, this paper uses the Probit model and the IVProbit model to test the impact of health fiscal expenditure on relative poverty in rural China. The study found that: first, with the expansion of health fiscal expenditure, the probability of rural residents falling into relative poverty increases; second, with the expansion of health fiscal expenditure, rural residents with poor health are more likely to fall into relative poverty than rural residents with good health; third, with the expansion of health fiscal expenditure, rural residents in the central and eastern regions are more likely to fall into relative poverty than rural residents in the western region. This paper suggests optimizing the structure of health fiscal expenditures, increasing the proportion of preventive expenditures, deepening the reform of public hospitals, and avoiding excessive expansion of public hospitals.

Out-of-pocket expenditure and catastrophic costs due to COVID-19 in Indonesia: A rapid online survey.

The Corona Virus Disease 2019 (COVID-19) pandemic has created a substantial socioeconomic impact, particularly in developing countries such as Indonesia. This study aimed to describe the COVID-19-related out-of-pocket spending of Indonesian citizens and the proportion of whom experienced catastrophic health spending during the COVID-19 pandemic using the patient's perspective. We conducted a rapid cross-sectional online survey across provinces in Indonesia to capture participants' experiences due to COVID-19. Data were collected between September 23rd to October 7th of 2021 including demographics, income, and expenditures. Descriptive statistics were used to analyze the respondents' characteristics. Patients's perspective of total cost was estimated from out-of-pocket of COVID-19 direct costs and compared them to total expenditure. If the proportion of COVID-19 total costs exceeded 40% of the total expenditure, the respondents were deemed to have faced catastrophic costs. A total of 1,859 respondents answered the questionnaire. The average monthly income and expenditure of respondents were 800 USD, and 667 USD respectively. The monthly expenditure was categorized into food expenditure (367 USD) and non-food expenditure (320 USD). The average of COVID-19-related monthly expenditure was 226 USD, including diagnostic expenditure (36 USD), preventive expenditure (58 USD), medical expenditure (37 USD for COVID-19 treatment; and 57 USD for post-COVID-19 medical expenses), and non-medical expenditure (30 USD). Analysis showed that 18.6% of all respondents experienced catastrophic costs while 38.6% of the respondents who had COVID-19 treatment experienced catastrophic costs. The high proportion of catastrophic costs among respondents suggests the need for COVID-19 social protection, especially for COVID-19 diagnostic and prevention costs. The survey findings have led the government to increase the benefit coverage other than medical costs at the hospitals.

The Importance of Drug Safety and the Strategies for Promoting it

With medications becoming the standard of treatment for many illnesses these days, drug safety has turned into a high priority in contemporary healthcare. Medicines might offer therapeutic benefits but carry side effects and risks. Drug safety is crucial for positive patient outcome, injury prevention, and lower healthcare expenditures. This particular paper offers a sweeping review of the significance of drug safety and also covers drug development, regulation, surveillance and control of unwanted side effects. The literature review points to the difficulty of drug safety because of patient variables including age, health condition and concurrent medicine. Specific care is required for vulnerable groups - people that are older, kids or even pregnant - who present considerable safety risks. Preclinical testing is informative but clinical trials with human subjects are still crucial for evaluating efficacy and drug safety before marketing. The paper discusses the crucial role of drug safety in public health and also offers views on its intricacy and advancement methods.

Sustainable Cotton Production through Skill Development among Farmers: Evidence from Khairpur District of Sindh, Pakistan

Pakistan is the world’s fourth largest producer and one of the major cottonexporting countries. Cotton is grown largely in Punjab and Sindh provinces and accounts for about 10.5 percent of the value-added in the agriculture sector. The majority of cotton growers are smallholders and a large number of them are tenant farm households. Frequent pest outbreaks since the early 1990s have induced pesticide-based farming in Pakistan. Also, the liberalisation of generic pesticide import has resulted in a many-fold increase in pesticide use in the country. However, this has neither increased cotton productivity nor the prosperity of the poor cotton growers [Poswal and Williamson (1998) and Ahmad and Poswal (2000)]. In Pakistan, research and development in Integrated Pest Management (IPM) was initiated in the 1970s. However, the efforts to implement IPM at the farm level were not very successful. Pesticides became a major instrument of production leading to a ‘pesticide treadmill’ situation [Irshad (2000)]. An analysis of pesticide policies through the UNDP-FAO Policy Reform Project paved the way for the establishment of a National IPM Programme and provided instruments to scale up farmer-led IPM through joint international and national efforts on various fronts. Pesticide policy studies estimated environmental and social cost of pesticides in Pakistan at US$ 206 million per year [UNDP (2001) and Azeem, et al. (2003)]. About 49 percent of these external costs were attributed to pest resistance problems, while 29 percent to loss in bio-diversity and nearly 20 percent occurred to human and animal health. On the other hand, damage prevention expenditures for residue monitoring and raising public awareness on the dangers of pesticides is less than 2 percent of the total social costs of pesticides.

Influencing factors of the high-quality economic development in China based on LASSO model

This paper constructs an index system for high-quality economic development in China from four dimensions: economic system, social system, environment system, and power system. The LASSO method was presented as screen indicators, then we use the panel fixed effect model to investigate the specific impact of key factors on high-quality economic development. The results indicate that: (1) Innovation-driven, infrastructure construction, green technology development, power supply, and efficient utilization of electrical equipment are the most important influencing factors to promote high-quality economic development. (2) Increasing financial expenditures for pollution prevention and control and strengthening the application of green technology will help to adjust the economic structure. (3) Building a complete green energy system will be an essential part of high-quality economic development. On this basis, heterogeneity analysis is carried out according to regional economic differences and power supply and demand positioning. These findings have great significance in high-quality economic development of China.

The impact of health insurance on self-protection of Chinese rural residents.

PurposeHealth insurance lowers the price of medical services, which reduces the insured's demand for self-protection (such as, live a healthy lifestyle or invest in disease prevention) that could help reduce the probability of getting sick, then ex ante moral hazard happens. The purpose of this study is to examine the impact and its heterogeneity of health insurance on the self-protection of Chinese rural residents.MethodThis study firstly builds a theoretical model of health insurance and self-protection. Then, based on the data from the 2004 to 2015 China Health and Nutrition Survey (CHNS), we adopt ordinary least squares model (OLS), probit model, and instrumental variable (IV) method to empirically investigate the impact of health insurance on Chinese rural residents' self-protection.ResultsAfter addressing the endogeneity problem, the study finds that participating in health insurance exerts a significant negative impact on the demand for self-protection. Specifically, health insurance participation not only increases residents' tendency toward drinking liquor by 3.4%, and that of having general obesity by 3.7%, but also reduces residents' preventive medical expenditure (PME) by 1.057%, increasing Body Mass Index (BMI) by 0.784 kg/m2. Further analysis shows that there is heterogeneity between groups, as health insurance participation reduces PME of people who are female, younger, and high-educated, and increases the tendency toward drinking liquor of people who are younger and low-educated.ConclusionsTo reduce the impact of ex ante moral hazard induced by health insurance, our findings suggest that it is necessary to improve the disease prevention function of health insurance and introduce a risk adjustment mechanism into the premium or co-payment design of health insurance.

The politics of public health investments

Public health investments help to prevent mortality and reduce health care costs. Yet very few studies have examined the determinants of preventive care investments across countries and over time. We develop a theory of health spending priorities contrasting preventive and curative care. Preventive care is particularly unlikely to be prioritized by governments since it is a public good that requires the allocation of scarce resources in the present to generate diffuse benefits that unfold only in the long-term. As such, public health is a “quiet” policy that is not supported by interest groups or public opinion. These characteristics have two implications: like other long-term investments, public health programs are particularly vulnerable to fiscal austerity, and prevention expenditures are not influenced by government partisanship since parties cannot attract votes with such low visibility, long term investments. We use a dataset covering 25 OECD countries from 1970 to 2018 to demonstrate that fiscal consolidations are negatively associated with the absolute level of preventive care and with its proportion relative to curative care. We also confirm that left-wing governments are not more likely to invest in public health than right-wing governments. Finally, contributing to the literature on comparative health care systems, we show that National Health Services systems maintain higher preventive care investments than Social Health Insurance systems.

The MCPF under the pandemic

AbstractThis study examines the marginal cost of public funds (MCPF) to assess the optimality of preventive governmental expenditure based on the optimal nonlinear income taxation with preventive behaviors by both individuals and the government. We show that the optimal condition with respect to preventive government expenditure consists of two parts. One part reflects how the trade‐off between preventive expenditure and consumption should deviate from the laissez faire for high‐skilled and low‐skilled individuals, which is interpreted as the Pigou effect. The other part measures how mimickers benefit from preventive government expenditure, which is called the genetic effect. Whether the MCPF is greater than 1 or not depends on the relative magnitude of the Pigou effect and the genetic effect. Moreover, we examine the MCPF if the government cannot commit to a certain policy and if the types of individuals are completely separated and show that the Pigou effect should be modified.

Leader-follower equilibria to examine investment decisions in grid resilience-enhancing measures.

Large-area, long-duration power outages are increasingly common in the United States, and cost the economy billions of dollars each year. Building a strategy to enhance grid resilience requires an understanding of the optimal mix of preventive and corrective actions, the inefficiencies that arise when self-interested parties make resilience investment decisions, and the conditions under which regulators may facilitate the realization of efficient market outcomes. We develop a bi-level model to examine the mix of preventive and corrective measures that enhances grid resilience to a severe storm. The model represents a Stackelberg game between a regulated utility (leader) that may harden distribution feeders before a long-duration outage and/or deploy restoration crews after the disruption, and utility customers with varying preferences for reliable power (followers) who may invest in backup generators. We show that the regulator's denial of cost recovery for the utility's preventive expenditures, coupled with the misalignment between private objectives and social welfare maximization, yields significant inefficiencies in the resilience investment mix. Allowing cost recovery for a higher share of the utility's capital expenditures in preventive measures, extending the time horizon associated with damage cost recovery, and adopting a storm restoration compensation mechanism shift the realized market outcome toward the efficient solution. If about one-fifth of preventive resilience investments is approved by regulators, requiring utilities to pay a compensation of $365 per customer for a 3-day outage (about seven times the level of compensation currently offered by US utilities) provides significant incentives toward more efficient preventive resilienceinvestments.

Rural development funding and wildfire prevention: Evidences of spatial mismatches with fire activity

The European Union Rural Development Program (RDP) is a major driver of landscape change over time in Europe. In a context of climate and land use changes and consequent fire risk exacerbation, understanding the possible contribution of RDP measures to wildfire risk mitigation could help planning subsidies allocation criteria in a more efficient way for fire prevention. However, little is known on the links between the spatial allocation of RDP subsidies, relevant for wildfires prevention, and the spatial distribution of fire activity. Our study aims to fill this knowledge gap through an exploratory analysis carried out in Italy and based on fire activity indicators of the period 2007–2017, RDP expenditure at municipal level in the period 2017–2013, and a series of ancillary indicators. We selected RDP measures specifically addressing wildfires (direct prevention) and those whose implementation has an impact on fire regime (indirect prevention). Our results suggest a low association between RDP expenditure for fire-related measures and subsequent reduction of wildfire activity. Principal Component Analysis suggests a role of managed rural areas in mitigating fire activity, as well as a spatial mismatch between wildfire prevention expenditure and high fire activity contexts. We claim the need for a deeper integration of territorial planning information within the RDP funding allocation criteria. Also, integrating RDP indirect prevention measures within fire management plans would be a cost-effective approach to leverage the impact of public policies on wildfire risk management, by allocating the limited financial resources to high-risk areas.

Environmental Disclosure and Financial Performance of Listed Non-Financial Companies in Nigeria

This study examines the influence of environmental disclosure (ED) on financial performance of listed non-financial companies in Nigeria from 2013-2020. A sample of seventy-six (76) companies listed as non-financial was drawn from the population of one hundred and thirteen (113) companies. Audited annual reports and accounts were used for data extraction. The analysis was done using descriptive statistics and multiple regressions. Explanatory research designed was adopted in the study to find out the influence of ED on financial performance. Variables used include the ED measured using ordinal coding scheme based on GRI guidelines (G4) focusing on environmental prevention expenditure disclosure(EN40), Waste disposal, emission treatment and remediation cost disclosure (EN41), Prevention and environmental management cost disclosure (EN 41) used as proxies for independent variable and financial performances’ accounting and market based measures proxy by earnings per share and Tobin’s Q was used as the dependent variable. Robustness tests such as multicollonearity test, heteroscedasticity test, normality test and Hausman specification test were conducted to validate the results. The study revealed that there is positive significant relationship between EPED, WDCD, PMCD and EPS while negative with TQ of listed Nigerian non-financial companies. The study therefore, recommends that the management of listed non-financial companies in Nigeria should create awareness on the importance of EPED, WDCD, PMCD and the other benefit that can be derived by a company and investors as a result of engaging in environmental activities as this may create good relationship between the company and the environment and consequently will improve financial performance. And also professional accounting bodies in Nigeria like the ICAN and the ANAN should key into introducing environmental and sustainability reporting into their mandatory professional education programs as this is a contemporary issue in accounting development this will help accountants to be trained on environmental accounting and reporting.

Evaluation of natural disaster treatment efficiency in 27 Chinese provinces

AbstractResearch on disaster mitigation and prevention has tended to focus on the impact of natural disasters on the economy and strategies for risk reduction and mitigation. There has been significant research on disaster prevention and treatment efficiencies, however, most analyses have employed traditional data envelopment analysis (DEA) radial models that do not consider undesirable output. Differing from previous research, this study employed a non‐radial directional distance function DEA that included an undesirable output analysis to evaluate the natural hazard management efficiency in 27 provinces/municipalities/autonomous regions in China. Results show that: (a) economic losses from natural disasters were lower due to the increase in natural disaster prevention and control program expenditure; (b) the overall natural disaster control efficiencies varied significantly across the provinces; and (c) Tibet and Xinjiang, which have the lowest general disaster prevention efficiencies, could benefit from following the example set by provinces such as Sichuan and Guangdong, which have the highest disaster prevention efficiencies. Disaster prevention efficiencies measure the overall performance of each province in disaster prevention. This efficiency index is measured by input (disaster prevention expenditure) and output (number of natural disasters prevented and natural disaster economic losses), and its calculation method is the ratio of the actual value of each input and output to the target value. This ratio is called the efficiency score, and the efficiency score is between 0 and 1. An efficiency score of 1 represents the most efficient.

Investing preventive care and economic development in ageing societies: empirical evidences from OECD countries

BackgroundThe proportion of the elderly aged 65 years old or above will reach 16% in 2050 worldwide. Early investment in effective prevention would generally reduce the morbidity, complication, functional disability, and mortality of most chronic illnesses and save resources in both healthcare and social services. This research aims to investigate how the optimal allocation of medical resources between prevention and treatment adds value to the population’s health as well as examine the interaction between ageing, health, and economic performance.MethodsThis research undertakes ageing-health analyses by developing an economic growth model. Based on the Organization for Economic Co-Operation and Development (OECD) countries’ experiences over the period from 2000 to 2017, this research further examines the hypothesis that an ageing society could increase demand for preventive and curative healthcare.ResultsTheoretical analysis found that the prevention share for maximizing growth is the same as that for minimizing ill health and maximizing welfare; this share increases with treatment share and ageing ratios. Estimation results from OECD countries’ experiences indicate that when treatment share increases by 1%, the prevention demand increases by 0.036%. A one-percent increase in the ageing ratio yields a change in prevention share of 0.0368%. The optimal share of prevention health expenditure to GDP would be 1.175% when the prevalence rate of ill health isat 6.13%; a higher or lower share of prevention would be accompanied with a higher prevalence of ill health. For example, a zero and 1.358% preventive health expenditure would be associated with an 18.01% prevalence of ill health, while the current share of prevention of 0.237% is associated with a 10.26% prevalence of ill health.ConclusionThis study shows that appropriate prevention is associated with decreases in the prevalence rates of ill health, which in turn attains sustainable growth in productivity. Too much prevention, however, could lead to higher detection of new chronic diseases with mild severity, which would result in longer illness duration, and higher prevalence rates of ill health. With suitable allocation of medical resources, the economic growth rate will help to cancel out increases in healthcare spending for the elderly and for expenses needed for the improvement of the population’s health as a whole.

Assessing the Impact of Out-of-Pocket Expenditures for Prevention of COVID-19 Infection on Households: Evidence From Malaysia.

COVID-19 infection resulted in significant economic implications to patients as well as a considerable financial burden to the general population for preventive measures. A descriptive study was conducted among staff at one of the public universities in Malaysia to estimate the monthly out-of-pocket expenditures for preventive measures used for COVID-19 infection. The study tool includes questions on household out-of-pocket expenditure and the measurements of the impact of the expenditure on household income. It was found that the average cumulative monthly expenditures related to the preventive measures were US$ 45.90 (Ringgit Malaysia 187.77), which was 4.3% of the household income. The highest expenditures were for traditional and complementary medicine followed by nutraceutical/supplements and disposable facemask. 8% of the households in this study incurred more than ten per cents of their monthly household income for expenditures related to COVID-19 preventive measures. Several households are experiencing substantial financial implications for preventive measures related to COVID-19 infection. This study highlights the out-of-pocket expenditures incurred for preventive measures were substantial for certain households. Effective initiatives from the government on providing subsidized protective personal equipment and a cost-sharing approach could help to alleviate the household financial burden.

Averting expenditure on malaria: effects on labour productivity of maize farmers in Bunkpurugu-Nakpanduri District of Ghana

BackgroundMalaria has been one of the commonest diseases during farming season, which affects farmers’ health resulting in a reduction in the number of days spent on the farm. As a result, farmers are regularly trying to avert malaria infection through preventive measures. Motivated by this argument, this study sought to determine the effects of malaria averting expenditure on labour productivity of maize farmers in Bunkpurugu-Nakpanduri District in the Northern Region of Ghana.MethodsA cross-sectional primary data was collected from 194 maize farmers. Both descriptive and quantitative data analysis approaches were employed. Conditional mixed process was used to estimate the effects of malaria prevention expenditure on maize farmers’ labour productivity.ResultsThe study revealed that maize farmers incurred an average expenditure of GHc284.6 to prevent malaria annually. The result shows that factors that affect maize farmers’ malaria prevention expenditure include off-farm income, household size, presence of bushes around houses, presence of pregnant women and number of household members in school. Meanwhile, quantity of fertilizer, seed, weedicides, farming experience, age, ownership of motorbike and averting expenditure are significant determinants of maize labour productivity. The study revealed that farmers who spend more money to avert malaria attack are more labour productive.ConclusionsTherefore, this study recommends that Ministry of Health and Ministry of Food and Agriculture should collaborate and integrate health extension service on malaria in agricultural extension to educate farmers on the need to avert malaria. Farmers should be educated on malaria preventive strategies, such as clearing of bushes around houses, draining of stagnant water, sleeping in treated mosquito nets among others. Lastly, aside distribution of free mosquito nets to pregnant women, they should be subsidized and made available to all farmers for malaria prevention.