scholarly journals Financial implications of preterm birth during initial hospitalization: The extent and predictors of catastrophic health expenditure

2019 ◽  
Author(s):  
Hadzri Zainal ◽  
Maznah Dahlui ◽  
Tin Tin Su
Keyword(s):  
Intensive Care ◽  
Preterm Birth ◽  
Household Income ◽  
Health Expenditure ◽  
Neonatal Intensive Care ◽  
Catastrophic Health Expenditure ◽  
Health Coverage ◽  
Income Loss ◽  
Initial Hospitalization ◽  
Universal Health

ABSTRACTPreterm birth incidence has risen globally and the high cost of initial hospitalization poses financial burden to the family. This study assessed family cost at neonatal intensive care units of two hospitals in the state of Kedah, Malaysia. Family’s expenditure was obtained using a structured questionnaire. 126 families who were government employed spent a mean total cost of MYR 549 (MYR 0 - MYR 4,700) compared to MYR 650 (MYR 40 – MYR 9,300) for 244 families who were not government employed. Mean income loss was MYR 310 (MYR 0 – MYR 15,000) and MYR 348 (MYR 0 – MYR 5,500) respectively. Travel expenses was the cost driver for all families. 15% of families in this study were already living below the income poverty line and majority were not government employed. For the rest of the families, 21% became impoverished when one month household income was used for hospitalization cost but this lowered to 9% with cumulative household income by length of hospital stay. Overall incidence of catastrophic health expenditure among families was 38%. Using multivariable logistic regression household income and residential location were predictive factors for catastrophic health expenditure. Despite universal health coverage through subsidy of direct medical (hospital) cost, the high incidence of catastrophic health expenditure and impoverishment among families of preterm infants was attributable to out of pocket payment for direct non-medical cost (such as travel and food) and indirect cost from income loss. Government employed families with an array of employment benefits appear better protected against financial hardship compared to those in private sector or self-employed. Remedial measures include improving neonatal intensive care unit rooming-in service for mothers, complementary financial assistance for families and enhancing universal health coverage through affordable social health insurance for infant healthcare.

scholarly journals Measuring the Direct Cost Burden of Illness in Burkina Faso

2018 ◽  
Vol 10 (4) ◽  
pp. 60
Author(s):  
Ousmane Traoré
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Direct Cost ◽  
Health Expenditure ◽  
Burden Of Illness ◽  
Methodological Approach ◽  
Catastrophic Health Expenditure ◽  
Cost Burden ◽  
Health Coverage ◽  
Universal Health

In this article, we evaluate the direct cost burden of illness in Burkina Faso. The methodological approach predicts the normative health expenditure based on the population’s health risk factors and adjusts the income based on people’s asset portfolios, which are supposed to influence their ability to manage shocks, or their vulnerability to shocks like illness. Thus, using the National Institute for Statistics and Demography’s priority surveys database of 1996, our methodology leads to a better information on the distributions of income and health care spending across a subsample of 1022 treated individuals. Subsequently, the average of the direct cost burden of illness is 11.17%, and 50% of the population spend more than 10.52% of their adjusted income on normative health care. Otherwise, there is a difference of 66.84 of percentage points between the highest and lowest cost burdens. Overall, women face higher direct costs burden compared to men. Given the “catastrophic health expenditure” threshold conventionally set at 10% of income, to decrease these financial vulnerabilities and inequalities in Burkina Faso, one solution would be to achieve universal health coverage.

scholarly journals Cost of preterm birth during initial hospitalization: A care provider’s perspective

2019 ◽  
Author(s):  
Hadzri Zainal ◽  
Maznah Dahlui ◽  
Shahrul Aiman Soelar ◽  
Tin Tin Su
Keyword(s):  
Intensive Care ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Care Provider ◽  
Neonatal Intensive Care ◽  
Cost Driver ◽  
Fixed Costs ◽  
Activity Based Costing ◽  
Initial Hospitalization ◽  
Provider Cost

ABSTRACTPreterm birth incidence has risen globally and remains a major cause of neonatal mortality despite improved survival. The demand and cost of initial hospitalization has also increased. This study assessed care provider cost in neonatal intensive care units of two hospitals in the state of Kedah, Malaysia. It utilized universal sampling and prospectively followed up preterm infants till discharge. Care provider cost was assessed using mixed method of top down approach and activity based costing. A total of 112 preterm infants were recruited from intensive care (93 infants) and minimal care (19 infants). Majority were from the moderate (23%) and late (36%) preterm groups followed by very preterm (32%) and extreme preterm (9%). Mean total cost per infant increased with level of care and degree of prematurity from MYR 2,751 (MYR 374 - MYR 10,103) for preterm minimal care, MYR 8,478 (MYR 817 - MYR 47,354) for late preterm intensive care to MYR 41,598 (MYR 25,351- MYR 58,828) for extreme preterm intensive care. Mean cost per infant per day increased from MYR 401 (MYR 363- MYR 534), MYR 444 (MYR 354 – MYR 916) to MYR 532 (MYR 443-MYR 939) respectively. Cost was dominated by overhead (fixed) costs for general (hospital), intermediate (clinical support services) and final (NICU) cost centers where it constituted at least three quarters of mean admission cost per infant while the remainder was consumables (variable) costs. Breakdown of overhead cost showed NICU specific overhead contributing at least two thirds of mean admission cost per infant. Personnel salary made up three quarters of NICU specific overhead. Laboratory investigation was the cost driver for consumables ranging from 29% (intensive care) to 84% (minimal care) of mean total consumables cost per infant. Gender, birth weight and length of stay were significant factors and cost prediction was developed with these variables.

scholarly journals Achieving SDG 3.8.2: Financial Protection Against Catastrophic Health Expenditure in Malaysia

2020 ◽  
Author(s):  
Surianti Sukeri ◽  
Muaz Sayuti
Keyword(s):  
At Risk ◽  
Universal Health Coverage ◽  
Health Expenditure ◽  
Health Spending ◽  
Safety Net ◽  
Catastrophic Health Expenditure ◽  
P Value ◽  
Financial Protection ◽  
Health Coverage ◽  
Universal Health

Abstract Background: The Sustainable Development Goal (SDG) 3.8.2 is one of the two indicators to monitor a country's progress towards universal health coverage. It concerns the financial protection against catastrophic spending on health based on the budget share approach. The purpose of this study is twofold: 1) to measure SDG 3.8.2 on the proportion of households with catastrophic health expenditure (CHE), and 2) to determine households at risk of CHEMethods: A cross-sectional study was conducted using secondary data from the 2015/2016 Household Expenditure Survey. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. The World Health Organization method of calculating CHE was applied in the calculation, and a threshold of 10% out-of-pocket health spending from total household expenditures was used to determine CHE. Data were analysed descriptively, and multiple logistic regression was used to determine factors associated with CHE.Results: A total of 13015 households were involved in the study. The proportion of CHE was 2.8%. Four associated factors that were statistically significant were female-headed household (Adjusted OR 1.6; CI 1.25, 2.03; p-value <0.001), household that lived in rural area (Adjusted OR 1.29; 95% CI 1.04, 1.61; p-value =0.022), small household size (Adjusted OR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and head of household aged below 60 years old (Adjusted OR2.34; 95% CI 1.81, 3.18; p-value <0.001).Conclusions: The low proportion of CHE revealed that Malaysia is on the right track towards achieving SDG 3.8 on universal health coverage status by 2030. However there is an increasing trend in the proportion of CHE. Households at risk of CHE require financial protection to afford healthcare and safety net measures to prevent from spiralling further into the vicious cycle of illness and poverty.

scholarly journals Mothers and fathers in NICU: The impact of preterm birth on parental distress

2016 ◽  
Vol 12 (4) ◽  
pp. 604-621 ◽  
Author(s):  
Chiara Ionio ◽  
Caterina Colombo ◽  
Valeria Brazzoduro ◽  
Eleonora Mascheroni ◽  
Emanuela Confalonieri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Birth ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Post Partum ◽  
Event Scale ◽  
Mothers And Fathers ◽  
Negative Feelings ◽  
The Impact

Preterm birth is a stressful event for families. In particular, the unexpectedly early delivery may cause negative feelings in mothers and fathers. The aim of this study was to examine the relationship between preterm birth, parental stress and negative feelings, and the environmental setting of NICU. 21 mothers (age = 36.00 ± 6.85) and 19 fathers (age = 34.92 ± 4.58) of preterm infants (GA = 30.96 ± 2.97) and 20 mothers (age = 40.08 ± 4.76) and 20 fathers (age = 40.32 ± 6.77) of full-term infants (GA = 39.19 ± 1.42) were involved. All parents filled out the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact of Event Scale Revised, Profile of Mood States, the Multidimensional Scale of Perceived Social Support and the Post-Partum Bonding Questionnaire. Our data showed differences in emotional reactions between preterm and full-term parents. Results also revealed significant differences between mothers and fathers’ responses to preterm birth in terms of stress, negative feelings, and perceptions of social support. A correlation between negative conditions at birth (e.g., birth weight and Neonatal Intensive Care Unit stay) and higher scores in some scales of Impact of Event Scale Revised, Profile of Mood States and Post-Partum Bonding Questionnaire were found. Neonatal Intensive Care Unit may be a stressful place both for mothers and fathers. It might be useful to plan, as soon as possible, interventions to help parents through the experience of the premature birth of their child and to begin an immediately adaptive mode of care.

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