Medical Tourism's Impact on Health Care Equity and Access in Low- and Middle-Income Countries: Making the Case for Regulation

2013 ◽  
Vol 41 (1) ◽  
pp. 286-300 ◽  
Author(s):  
Y.Y. Brandon Chen ◽  
Colleen M. Flood
Keyword(s):  
Medical Tourism ◽  
Developed Countries ◽  
Middle Income ◽  
Medical Treatments ◽  
Middle Income Countries ◽  
Medical Travel ◽  
Health Care Equity ◽  
Number Of Patients ◽  
Novel Concept ◽  
Low And Middle Income

Travelling internationally to acquire medical treatments otherwise unavailable or inaccessible in one’s home country is not a novel concept. Conventionally, such medical travel largely entailed patients from developed countries or wealthy patients from the developing world seeking care in Western facilities like the Mayo Clinic in the U.S. and myriad private clinics along Harley Street in London, England. What is different about the topical phenomenon known as “medical tourism” is the growing trend of health services export in the opposite direction. The number of patients travelling from the developed world to low- and middle-income countries (LMICs) for treatments has ballooned in recent years, primarily driven by difficulties with accessing affordable care at home. According to a liberal estimate by the Deloitte Center for Health Solutions, the number of Americans travelling abroad for care rose from 750,000 in 2007 to 1.6 million in 2012. On the flip side, Thailand reportedly treated a total of 1.3 million foreign nationals in 2007, which represented a 16% leap from 2001.

scholarly journals An International Analysis of Dialysis Services Reimbursement

2018 ◽  
Vol 14 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Arjan van der Tol ◽  
Norbert Lameire ◽  
Rachael L. Morton ◽  
Wim Van Biesen ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Gdp Per Capita ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients ◽  
Kidney Replacement Therapy ◽  
Per Capita ◽  
Low And Middle Income

Background and objectivesThe prevalence of patients with ESKD who receive extracorporeal kidney replacement therapy is rising worldwide. We compared government reimbursement for hemodialysis and peritoneal dialysis worldwide, assessed the effect on the government health care budget, and discussed strategies to reduce the cost of kidney replacement therapy.Design, setting, participants, & measurementsCross-sectional global survey of nephrologists in 90 countries to assess reimbursement for dialysis, number of patients receiving hemodialysis and peritoneal dialysis, and measures to prevent development or progression of CKD, conducted online July to December of 2016.ResultsOf the 90 survey respondents, governments from 81 countries (90%) provided reimbursement for maintenance dialysis. The prevalence of patients per million population being treated with long-term dialysis in low- and middle-income countries increased linearly with Gross Domestic Product per capita (GDP per capita), but was substantially lower in these countries compared with high-income countries where we did not observe an higher prevalence with higher GDP per capita. The absolute expenditure for dialysis by national governments showed a positive association with GDP per capita, but the percent of total health care budget spent on dialysis showed a negative association. The percentage of patients on peritoneal dialysis was low, even in countries where peritoneal dialysis is better reimbursed than hemodialysis. The so-called peritoneal dialysis–first policy without financial incentive seems to be effective in increasing the utilization of peritoneal dialysis. Few countries actively provide CKD prevention.ConclusionsIn low- and middle-income countries, reimbursement of dialysis is insufficient to treat all patients with ESKD and has a disproportionately high effect on public health expenditure. Current reimbursement policies favor conventional in-center hemodialysis.

Opportunities and Challenges for Implementing Neurotrauma Prevention Program: A Practical Perspective for Developing Countries

2019 ◽  
Vol 16 (02/03) ◽  
pp. 077-081
Author(s):  
Amrita Ghosh ◽  
Ranabir Pal ◽  
Luis Rafael Moscote-Salazar ◽  
Huber Said Padilla-Zambrano ◽  
Harsh Deora ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Developed Countries ◽  
Public Health Issue ◽  
Evidence Based ◽  
Middle Income ◽  
Literature Research ◽  
Middle Income Countries ◽  
Literature Searches ◽  
Low And Middle Income

AbstractNeurotrauma is an underestimated and less understood public health issue in low- and middle-income countries for which we need system-based approach to prevention plans. This study was initiated to find rationale of effective plan with projectile vision of neurotrauma prevention. In search of innovative ideas of neurotrauma prevention evidence was explored from the published literature research on traumatic brain injury. Evidence-based global guidelines on recommended content and scheduling on prevention of neurotrauma literature searches data were also synthesized and summarized from research in developed countries. Our study noted that a considerable number of victims of neurotrauma with death and disabilities put mammoth costs to the already compromised health systems of the low- and middle-income countries. We need systems-based four-pronged approach incorporating neurotrauma registry, neurotrauma surveillance, translational research programs, and current approved process for development of clinical guidelines for prevention.

scholarly journals Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India

2015 ◽  
Vol 9 (05) ◽  
pp. 505-511 ◽  
Author(s):  
Vishal Diwan ◽  
Yogesh D Sabde ◽  
Emma Byström ◽  
Ayesha De Costa
Keyword(s):  
Prescription Drugs ◽  
Urban Setting ◽  
Middle Income ◽  
Medical Treatments ◽  
Oral Rehydration ◽  
Middle Income Countries ◽  
Dispensing Practices ◽  
Tract Infections ◽  
Recommended Guidelines ◽  
Low And Middle Income

Introduction: In low- and middle-income countries such as India, private pharmacies play an important role in medical treatments, offering advice for common illnesses such as diarrhea and respiratory tract infections. There is a need to explore the details of the dispensing practices at the private pharmacies in low- and middle-income countries. Methodology: The present study used simulated client methodology to assess the actual dispensing practices for patients with pediatric diarrhea at private pharmacies in an urban setting of an Indian province. Results: This study identified 164 private pharmacies (84.10%) in the study setting that engaged in the practice of dispensing prescription drugs without prescriptions. Only about 40% asked clients if they had a prescription from a doctor. The average duration of consultations at the pharmacies was 1.3 minutes (range, 0.5–6 minutes). The dispensing of drugs was not in compliance with the recommended guidelines and regulations. The most commonly dispensed drugs were antibiotics (40.24%); of these, quinolones either alone or in combination with imidazoles were the most frequently dispensed. The other commonly dispensed drugs were antimotility drugs (31.10%) and Lactobacillus acidophilus (probiotics; 23.17%). The drugs were dispensed in inappropriate doses due to the absence of indications. Conclusions: Overuse and misuse of all these prescription drugs dispensed by pharmacies pose significant issues, such as resistance, dangerous side effects, and high costs. At the same time, the pharmacies did not dispense recommended drugs such as oral rehydration solution and zinc, which they are authorized to dispense without a prescription.

scholarly journals Global Breast Cancer: The Lessons to Bring Home

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Silvia C. Formenti ◽  
Alan A. Arslan ◽  
Susan M. Love
Keyword(s):  
Breast Cancer ◽  
Developed Countries ◽  
Effective Management ◽  
Middle Income ◽  
Western Countries ◽  
Middle Income Countries ◽  
Common Cancer ◽  
The Us ◽  
Low And Middle Income

Breast cancer is the most common cancer affecting women globally. This paper discusses the current progress in breast cancer in Western countries and focuses on important differences of this disease in low- and middle-income countries (LMCs). It introduces several arguments for applying caution before globalizing some of the US-adopted practices in the screening and management of the disease. Finally, it suggests that studies of breast cancer in LMCs might offer important insights for a more effective management of the problem both in developing as well as developed countries.

scholarly journals Strategies for neonatal care during the COVID-19 pandemic: a lower middle-income country perspective

2021 ◽  
Vol 8 (5) ◽  
pp. 950
Author(s):  
Rajat Grover ◽  
Shantanu Shubham ◽  
Sriparna Basu
Keyword(s):  
Developed Countries ◽  
Neonatal Care ◽  
Limited Resources ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Load ◽  
Level 3 ◽  
Neonates And Infants ◽  
Precarious Situation ◽  
Low And Middle Income

COVID-19 has transformed into an all-encompassing pandemic affecting all levels of healthcare throughout the globe. The strains on healthcare systems have been evident even in the most developed countries. Low and middle income countries (LMICs), especially India, find themselves in a precarious situation due to limited resources, poor healthcare worker population ratios and a bigger population. Multiple factors can exponentially increase the actual effect of a pandemic on the vulnerable neonates and infants even though the disease itself may be less lethal for them. The situation was complicated by the implementation of lockdowns. We discuss the implications for neonatal care that such a pandemic has in LMICs and elucidate the strategies we have implemented to provide continuity of care during the pandemic. We also share our experience of providing neonatal care and summarise the patient load witnessed in a specific context of a level-3 NICU in a government multi-speciality hospital of an LMIC. Keywords: Covid-19 pandemic; Low- and middle-income countries; Neonatal care

scholarly journals Child Disability and Caregiving in Low and Middle Income Countries: Big Data Approach on open data

2020 ◽  
Author(s):  
Andrea Bizzego ◽  
Mengyu Lim ◽  
Greta Schiavon ◽  
Setoh Peipei ◽  
Giulio Gabrieli ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Open Data ◽  
Developed Countries ◽  
Child Disability ◽  
Severe Condition ◽  
Middle Income ◽  
Middle Income Countries ◽  
Large N ◽  
Research Bias ◽  
Low And Middle Income

Background: The presence of child disabilities might affect the amount of caregiving attention the child receives, with potential ramifications on the development of the child and increasing the likelihood of developing a more severe condition. Little is known about the association between child disabilities and caregiving practices in less developed countries, penalized by both lack of data and a research bias toward western societies.Method: In this study, we apply data mining methods on a large (N = 29,525) dataset from UNICEF to investigate the association between caregiving practices and developmental disabilities of the children, and highlight the differences between intellectual and other disabilities.Results: Our results highlight that, compared to other types of disabilities, intellectual disabilities increased the risk of being neglected by the caregiver in those activities oriented to the cognitive development. The education of the caregiver and the socioeconomical development of the country are actively involved in the moderation of the risk.Conclusion: We demonstrated that educational policies of parental training, such as psychoeducation regarding intellectual disabilities and destigmatization campaigns, are needed to benefit parental practices in low- and middle-income countries.

Are low- and middle-income countries profiting from fast fashion?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karan Khurana ◽  
S.S. Muthu
Keyword(s):  
Economic Development ◽  
Value Chain ◽  
Developed Countries ◽  
Environmental Cost ◽  
Fast Fashion ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

PurposeIn the last two decades, the fashion value chain traveled to developing parts of the world. To these nations, it paved a path for socio-economic development initially but lately, the aftermath has costed more. This article visualizes the gains and losses of fast fashion to these countries.Design/methodology/approachAn in-depth systematic literature review was performed to analyze the secondary data from academic journals and reports from international organizations. The authors have compiled their empirical journeys in academia, research and industry from low- and middle-income countries (LMICs) based on Schon's (1983, 1990) theory of reflective practice. Further on, the article is structured using the value chain analysis (VCA) method which visualizes the aftermath of mass-producing fashion for the developed countries.FindingsIn this research it was found that LMICs have made substantial economic progress in the past two decades, however at a high social and environmental cost. It is the right time to find a balance between economic development and harm caused to the citizens of these nations.Originality/valueAt the moment the existing academic literature talks about unsustainable practices in the fashion sector around the world. This research precisely targets the LMICs where the aftermath is supposed to be much more severe. Further, it provides solutions and urges these nations to bring a substantial change throughout the value chain for a robust future.

Sign in / Sign up

Export Citation Format

Share Document