Abstract:
OBJECTIVE:To estimate out-of-pocket costs and the incidence of catastrophic health expenditure in people admitted to hospital with acute coronary syndromes in Asia. METHODS:Participants were enrolled between June 2011 and May 2012 into this observational study in China, India, Malaysia, Republic of Korea, Singapore, Thailand and Viet Nam. Sites were required to enrol a minimum of 10 consecutive participants who had been hospitalized for an acute coronary syndrome. Catastrophic health expenditure was defined as out-of-pocket costs of initial hospitalization > 30% of annual baseline household income, and it was assessed six weeks after discharge. We assessed associations between health expenditure and age, sex, diagnosis of the index coronary event and health insurance status of the participant, using logistic regression models. FINDINGS:Of 12,922 participants, 9370 (73%) had complete data on expenditure. The mean out-of-pocket cost was 3237 United States dollars. Catastrophic health expenditure was reported by 66% (1984/3007) of those without insurance versus 52% (3296/6366) of those with health insurance (P < 0.05). The occurrence of catastrophic expenditure ranged from 80% (1055/1327) in uninsured and 56% (3212/5692) of insured participants in China, to 0% (0/41) in Malaysia. CONCLUSION:Large variation exists across Asia in catastrophic health expenditure resulting from hospitalization for acute coronary syndromes. While insurance offers some protection, substantial numbers of people with health insurance still incur financial catastrophe. OBJECTIF:Estimer les coûts directs ainsi que l'incidence des dépenses de santé catastrophiques pour les personnes admises à l'hôpital avec un syndrome coronarien aigu en Asie. Les participants ont été inscrits à cette étude par observation entre juin 2011 et mai 2012 en Chine, en Inde, en Malaisie, en République de Corée, à Singapour, en Thaïlande et au Viet Nam. Les sites devaient recruter au minimum 10 participants consécutifs ayant été hospitalisés pour un syndrome coronarien aigu. Les dépenses de santé catastrophiques ont été définies comme les coûts directs d'hospitalisation initiale > 30% du revenu annuel de référence des ménages, et ont été estimées six semaines après la sortie de l'hôpital. Nous avons évalué les associations entre les dépenses de santé et l'âge, le sexe, le diagnostic de l'affection coronarienne en question et la couverture d'assurance maladie des participants, à l'aide de modèles de régression logistique. Sur les 12 922 participants, 9370 (73%) disposaient de données complètes sur les dépenses. Les coûts directs moyens s'élevaient à 3237 dollars des États-Unis. Des dépenses de santé catastrophiques ont été rapportées par 66% (1984/3007) des personnes sans assurance contre 52% (3296/6366) des personnes ayant une assurance maladie (P < 0,05). L'occurrence de dépenses de santé catastrophiques allait de 80% (1055/1327) des participants non assurés et 56% (3212/5692) des participants assurés en Chine, à 0% (0/41) en Malaisie. CONCLUSION:Les pays d'Asie présentent de gros écarts en matière de dépenses de santé catastrophiques suite à une hospitalisation pour des syndromes coronariens aigus. Si le fait d'être assuré offre une certaine protection, un grand nombre de personnes ayant une assurance maladie font encore face à des catastrophes financières. OBJETIVO:Estimar los costes directos y la incidencia del gasto sanitario catastrófico en las personas admitidas en hospitales que sufren síndromes coronarios agudos en Asia. MÉTODOS:Los participantes se inscribieron entre junio de 2011 y mayo de 2012 en este estudio de observación en China, India, Malasia, la República de Corea, Singapur, Tailandia y Vietnam. Se solicitó a cada país que inscribiera un mínimo de 10 participantes consecutivos que hubieran sido hospitalizados por un síndrome coronario agudo. El gasto sanitario catastrófico se definió como costes directos de hospitalización inicial > 30% de los ingresos familiares anuales de referencia, y se evaluó seis semanas después de recibir el alta hospitalaria. Se evaluó la relación entre el gasto sanitario y la edad, el sexo, el diagnóstico del caso coronario y la situación del seguro sanitario del participante, mediante modelos de regresión logística. RESULTADOS:De 12 922 participantes, 9 370 (73%) tenían datos completos sobre el gasto. El coste directo medio fue de 3 237 dólares estadounidenses. El gasto sanitario catastrófico se registró en un 66% (1 984/3 007) de aquellos pacientes que no contaban con seguro, frente a un 52% (3 296/6 366) de los que contaban con seguro (P < 0,05). La aparición de gastos catastróficos variaba de un 80% (1 055/1 327) de participantes sin seguro y un 56% (3 212/5 692) de participantes asegurados en China a un 0% (0/41) en Malasia. CONCLUSIÓN:Existe una gran variación en Asia en lo referente al gasto sanitario catastrófico derivado de la hospitalización por síndromes coronarios agudos. Aunque los seguros ofrecen cierta protección, existe un gran número de personas con seguro sanitario que aún incurren en catástrofe financiera. الغرض:تقدير التكاليف المدفوعة من جانب المريض وأسرته ووقوع حالات من الإنفاق الصحي الباهظ للأشخاص الذين يدخلون المستشفى لإصابتهم بمتلازمات الشريان التاجي الحادة في آسيا. الطريقة:تم تسجيل المشاركين في الفترة من يونيو/حزيران عام 2011 ومايو/أيار عام 2012 في هذه الدراسة الرصدية في الصين والهند وماليزيا وجمهورية كوريا وسنغافورة وتايلند وفييت نام. وكانت المواقع ملزمة بتسجيل ما لا يقل عن 10 مشاركين عولجوا على التوالي بالمستشفى لإصابتهم بمتلازمة الشريان التاجي الحادة. وقد تم تعريف النفقات الصحية الباهظة بأنها التكاليف المدفوعة من جانب المريض وأسرته عند الدخول إلى المستشفى لتلقي العلاج أول مرة > 30% من الدخل السنوي للأسرة عند خط الأساس، وتم تقييم هذه النفقات بمرور ستة أسابيع بعد الخروج من المستشفى. قمنا بتقييم علاقات الاقتران بين النفقات الصحية والعمر والجنس وتشخيص مؤشر حالة الشريان التاجي ووضع التأمين الصحي للمشارك، وذلك باستخدام نماذج التحوف اللوجيستي. النتائج:من بين 12,922 مشاركًا، كان لدى 9370 مشاركًا (بنسبة 73%) البيانات الكاملة عن النفقات. بلغ متوسط النفقات المدفوعة من جانب المريض أو أسرته 3237 دولارًا أمريكيًا. وتم الإبلاغ عن النفقات الصحية الباهظة من جانب الأشخاص الذين لا يغطيهم التأمين الصحي بنسبة 66% (1984/3007) في مقابل أولئك الأشخاص الذين يغطيهم التأمين الصحي بنسبة 52% (3296/6366) (الاحتمال < 0.05). تراوح معدل حدوث النفقات الباهظة بنسبة تبلغ 80% (1055/1327) عند الأشخاص غير المؤمن عليهم وبنسبة 56% (3212/5692) عند المشاركين المؤمن عليهم في الصين، إلى 0% (0/41) في ماليزيا. النتائج:من بين 12,922 مشاركًا، كان لدى 9370 مشاركًا (بنسبة 73%) البيانات الكاملة عن النفقات. بلغ متوسط النفقات المدفوعة من جانب المريض أو أسرته 3237 دولارًا أمريكيًا. وتم الإبلاغ عن النفقات الصحية الباهظة من جانب الأشخاص الذين لا يغطيهم التأمين الصحي بنسبة 66% (1984/3007) في مقابل أولئك الأشخاص الذين يغطيهم التأمين الصحي بنسبة 52% (3296/6366) (الاحتمال < 0.05). تراوح معدل حدوث النفقات الباهظة بنسبة تبلغ 80% (1055/1327) عند الأشخاص غير المؤمن عليهم وبنسبة 56% (3212/5692) عند المشاركين المؤمن عليهم في الصين، إلى 0% (0/41) في ماليزيا. 目的:旨在评估亚洲急性冠心病住院病人灾难性卫生支出的自费费用和发生率。. 方法:2011 年 6 月至 2012 年 5 月间,受访者报名参加本次在韩国、马来西亚、泰国、新加坡、越南、印度和中国开展的观察性调查。每个调查地至少需 10 名可连续参与的受访者,且其曾因急性冠心病入院治疗。灾难性卫生支出指初次住院治疗的自费部分超出家庭年收入基准的 30%,且其在费用报销六个星期后予以评估。我们通过逻辑回归模型,评估了卫生支出与年龄、性别、冠心病诊断指标和受访者医疗保险状态之间的联系。. 结果:12 922 名受访者中,9370 (73%) 具备完整的支出数据。自费平均费用为 3237 美元。其中,未参保的受访者中,66% (1984/3007) 报告称发生灾难性卫生支出,而参加医疗保险的受访者中,52% (3296/6366) 报告称发生灾难性卫生支出 (P < 0.05)。灾难性支出发生率从中国未参保的 80% (1055/1327) 和参保的 56% (3212/5692) 到马来西亚的 0% (0/41)。. 结论:急性冠心病治疗引起的灾难性卫生支出在亚洲地区存在很大差异。尽管保险提供某种保障,但大批参加医疗保险的人群仍旧会出现重大财务问题。. Цель:Подсчитать выплаты из собственных средств пациентов и долю катастрофических расходов на здравоохранение среди людей, госпитализированных с острым коронарным синдромом, в Азии. Методы:Участники были включены в обсервационное исследование в период с июня 2011 г. по май 2012 г. во Вьетнаме, Индии, Китае, Малайзии, Республике Корея, Сингапуре и Таиланде. Для исследования как минимум 10 участников подряд, госпитализированных по причине острого коронарного синдрома, понадобились специальные центры. Катастрофические расходы на здравоохранение составили выплаты из собственных средств пациентов при первоначальной госпитализации, превышающие 30% базового уровня годового дохода семьи. При этом оценка проводилась через 6 недель после выписки из стационара. Была проведена оценка взаимосвязи между расходами на здравоохранение и возрастом, полом, показателями диагностирования индексного коронарного синдрома и наличием медицинской страховки пациента с помощью моделей логистической регрессии. Результаты:Из 12 922 участников 9 370 (73%) предоставили полные данные о расходах. В среднем выплаты из собственных средств пациентов составили 3 237 долларов США. О катастрофических расходах на здравоохранение сообщили 66% (1 984 из 3 007) пациентов из тех, у кого медицинская страховка отсутствовала, против 52% (3 296 из 6 366) пациентов из тех, кто обладал медицинской страховкой (P<0,05). Частотность катастрофических расходов варьировалась от 80% (1 055 из 1 327) среди незастрахованных и 56% (3 212 из 5 692) застрахованных участников в Китае до 0% (0 из 41) в Малайзии. Вывод:Существует большая разница между странами Азии в отношении катастрофических расходов на здравоохранение, вызванных госпитализацией при остром коронарном синдроме. Несмотря на то что страхование предоставляет определенную защиту, значительное количество людей, имеющих медицинскую страховку, терпят финансовый крах в вопросах здравоохранения.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
Jan S,Lee SW,Sawhney JP,Ong TK,Chin CT,Kim HS,Krittayaphong R,Nhan VT,Itoh Y,Huo Ydoi
10.2471/BLT.15.158303subject
Has Abstractpub_date
2016-03-01 00:00:00pages
193-200issue
3eissn
0042-9686issn
1564-0604pii
BLT.15.158303journal_volume
94pub_type
杂志文章abstract::Until about 10 years ago heparin was prepared from ox lungs and was regarded as a homogeneous polymer (of a sulfated mucopolysaccharide) with a relatively constant biological activity of about 100 IU/mg. The mucus and mucosa of the intestine of hog, sheep and ox have now become the main industrial source of bulk start...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1970-01-01 00:00:00
abstract::The availability of affordable medicines is a major barrier to providing high-quality health care in many countries. Fatima Suleman talks to Fiona Fleck. ...
journal_title:Bulletin of the World Health Organization
pub_type: 传,历史文章,新闻
doi:10.2471/BLT.17.031217
更新日期:2017-12-01 00:00:00
abstract::Asthma is a very common chronic disease that occurs in all age groups and is the focus of various clinical and public health interventions. Both morbidity and mortality from asthma are significant. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide is similar to that for diabetes, liver ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract::The operational and diagnostic performance of a two-step method for the cost-effective screening of urinary schistosomiasis was investigated in the Kilosa District of east-central Tanzania. In the first step a simple questionnaire was administered to 15,073 primary schoolchildren by their class teachers over a 4-week ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of diabetes and prediabetes in Bangladesh using national survey data and to identify risk factors. METHODS:Sociodemographic and anthropometric data and data on blood pressure and blood glucose levels were obtained for 7541 adults aged 35 years or more from the biomarker sample of t...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.13.128371
更新日期:2014-03-01 00:00:00
abstract::Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost o...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Present methods of controlling meningococcal cerebrospinal meningitis have failed to contain the disease. This has led to the search for effective vaccines and to the development of methods for assaying the potency of these vaccines, as well as for measuring the immune response of the individual. The feasibility of us...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1969-01-01 00:00:00
abstract::Coordinated global efforts to prevent and control malaria have been a tour-de-force for public health, but success appears to have reached a plateau in many parts of the world. While this is a multifaceted problem, policy strategies have largely ignored genetic variations in humans as a factor that influences both sel...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:10.2471/BLT.11.087320
更新日期:2011-11-01 00:00:00
abstract::This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has been designed by WHO ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:/S0042-96862005000900014
更新日期:2005-09-01 00:00:00
abstract::Three methods were used to measure the level of transmission of infections of Schistosoma mansoni on an irrigated sugar estate in northern Tanzania. The studies were carried out over a period of 3 years, during a programme for the control of the host snail Biomphalaria pfeifferi. During the second and third years a ma...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1972-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the performance of serological tests using dried blood on filter-papers (micro-card agglutination test for trypanosomiasis (micro-CATT)) performed under field and laboratory conditions and using whole blood ((CATT/T.b. gambiense) (wb-CATT) and latex agglutination (LATEX/T.b. gambiense) (wb-LATEX))...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Tuberculosis (TB) is a major public health problem in eastern Europe. Since 1990, the incidence rates of TB have continued to increase in Belarus, the Russian Federation, the Ukraine and the central Asian republics of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan. Eastern Europe, and in particular the Russian Fede...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:10.2471/blt.06.034991
更新日期:2008-02-01 00:00:00
abstract::Pacific islanders face up to the dire health effects of global warming. Atasa Moceituba and Monique Tsang report. ...
journal_title:Bulletin of the World Health Organization
pub_type: 新闻
doi:10.2471/BLT.15.021115
更新日期:2015-11-01 00:00:00
abstract::Since an excellent candidate strain (M) for live virus vaccination of swine against Japanese encephalitis was developed, a number of large vaccination programmes have been implemented in Japan with the aim of controlling Japanese encephalitis epidemics in man by reducing the population size of nonimmune swine. Encoura...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1972-01-01 00:00:00
abstract::Villages associated with the Lesotho Highlands Development Agency were randomized with a bias in favour of larger villages, and children < 5 years of age from cluster-randomized households in these villages were chosen for the assessment of antibiotic resistance in pneumococci. Children of the same age group attending...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To assess the consistent availability of basic surgical resources at selected facilities in seven countries. METHODS:In 2010-2014, we used a situational analysis tool to collect data at district and regional hospitals in Bangladesh (n = 14), the Plurinational State of Bolivia (n = 18), Ethiopia (n = 19), Gua...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.16.175885
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:In 2000, a referral hospital in the Gambia accepted a donation of oxygen concentrators to help maintain oxygen supplies. The concentrators broke down and were put into storage. A case study was done to find the reasons for the problem and to draw lessons to help improve both oxygen supplies and the success of...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.07.042994
更新日期:2008-01-01 00:00:00
abstract::An autogenous species belonging to the Aedes (Stegomyia) scutellaris subgroup was found on the island of Tafahi, Kingdom of Tonga. A subcolony was established at Johns Hopkins University, Baltimore, Md., USA, where cross-breeding experiments were conducted with the Samoan strain of A. polynesiensis. The cross between ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1973-01-01 00:00:00
abstract::Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.08.051078
更新日期:2008-08-01 00:00:00
abstract::N-Tritylmorpholine (Frescon, WL 8008) is highly toxic to the intermediate-host snails of the Schistosomatidae. Molluscicidal concentrations range from 0.1 ppm to 0.5 ppm for 1-hour exposures and from 0.01 ppm to 0.05 ppm for 24-hour exposures. Under these conditions the compound is not toxic to snail eggs; recent work...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1967-01-01 00:00:00
abstract:OBJECTIVE:To assess the value of self-rated health assessments by examining the association between education and self-rated poor health. METHODS:We used the globally representative population-based sample from the 2002 World Health Survey, composed of 219,713 men and women aged 25 and over in 69 countries, to examine...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.09.067058
更新日期:2010-02-01 00:00:00
abstract::Twenty-six patients suffering from methylmercury poisoning were treated by different therapeutic regimes. Seven received penicillamine or N-acetyl-d-L-penicillamine, 10 were treated with dimercaprol sulfonate and 9, who could not be treated, were given a placebo and were used as controls. Penicillamine, N-acetyl-d-L-p...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::A large number of organisms such as viruses, protozoa, helminths, fungi and bacteria, especially mycobacteria, need cell-mediated immunological processes for their elimination. As well as being involved in protection, cell-mediated immunological processes are also involved in a number of allergic reactions to products...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.5935/0305-7518.19700030
更新日期:1969-01-01 00:00:00
abstract::A possible method for genetic control of insect vector species involves the use of translocation heterozygotes. The potential of single and double heterozygotes already available in Aedes aegypti has been investigated with computer simulations of release strategies. Such simulations indicate a possible role for transl...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1971-01-01 00:00:00
abstract::Current textbooks link influenza pandemics to influenza A virus subtypes H2 (1889-91), H3 (1990), H1 (1918-20), H2 (1957-58) and H3 (1968), a pattern suggesting subtype recycling in humans. Since H1 reappeared in 1977, whatever its origin, some workers feel that H2 is the next pandemic candidate. This report reviews t...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of oral ivermectin (IV) and two different modalities of topical benzyl benzoate (BB) for treating scabies in a community setting. METHODS:The trial included patients aged 5-65 years with scabies who attended the dermatology department at the Institut d'Hygiène Sociale in Dakar, S...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,随机对照试验
doi:10.2471/blt.08.052308
更新日期:2009-06-01 00:00:00
abstract:PROBLEM:In 1999, a tuberculosis (TB) crisis was declared in the Western Pacific Region. APPROACH:In response, WHO established the Stop TB Special Project, which sought to halve 2000 levels of TB prevalence and mortality by 2010 through first reaching the global 2005 TB targets. LOCAL SETTING:Particular issues in the ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.06.038521
更新日期:2007-05-01 00:00:00
abstract::Rabbits have commonly been used for testing the blood-level duration limit of penicillin, but have proved not to be entirely suitable. Experiments reported in this paper on the use of sheep suggest that these animals can be successfully used for the testing of procaine benzylpenicillin with aluminium monostearate (PAM...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1961-01-01 00:00:00
abstract::To obviate the foreign protein reactions experienced with the use of hyperimmune serum in rabies-exposed individuals, an attempt was made to produce a rabies antiserum of human origin.Five doses of an inactivated rabies virus duck-egg vaccine were administered to 34 volunteers at 4-day intervals (i.e., on days 0, 4, 8...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1959-01-01 00:00:00
abstract::As culture filtrates of Mycobacterium tuberculosis have been shown by numerous workers to be antigenically heterogeneous, a series of experiments has been started to identify some of the different antigens likely to be useful in laboratory tests for measuring the antibodies in human blood. The work involves the fracti...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1955-01-01 00:00:00