Abstract:
BACKGROUND:Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the economic burden associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the economic disease burden of HBV, we conducted a survey to investigate the direct economic burden of acute and chronic hepatitis B, cirrhosis and liver cancer caused by HBV-related disease. METHODS:From April 2010 to November 2010, we conducted a survey of inpatients with HBV-related diseases and who were hospitalized for seven or more days in one of the seven tertiary and six secondary hospitals in Shandong, China. Patients were recorded consecutively within a three-to-five month time period from each sampled hospital; an in-person survey was conducted to collect demographic and socio-economic information, as well as direct medical and nonmedical expenses during the last month and last year prior to the current hospitalization. Direct medical costs included total outpatient, inpatient, and self-treatment expenditures; direct nonmedical costs included spending on nutritional supplements, transportation, and nursing. Direct medical costs during the current hospitalization were also obtained from the hospital financial database. The direct economic cost was calculated as the sum of direct medical and nonmedical costs. Our results call for the importance of implementing clinical guideline, improving system accountability, and helping secondary and smaller hospitals to improve efficiency. This has important policy implication for the on-going hospital reform in China. RESULTS:Our data based on inpatients with HBV-related diseases suggested that the direct cost in US dollars for acute hepatitis B, severe hepatitis B, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis and primary liver cancer was $2954, $10834, $4552, $7400.28, $6936 and $10635, respectively. These costs ranged from 30.72% (for acute hepatitis B) to 297.85% (for primary liver cancer) of the average annual household income in our sample. Even for patients with health insurance, direct out-of-pocket cost of all HBV-related diseases except acute hepatitis B exceeded 40.00% of the patient's disposable household income, making it a catastrophic expenditure for the household. CONCLUSION:Hepatitis B imposes considerable economic burden on a family. Our findings will help health policy makers' understanding of the magnitude of the economic burden of HBV-related diseases in China. Evidence from our study also contributes to our understanding of potential benefits to society from allocating more resources to preventing and treating HBV infection, as well as increasing insurance coverage in China. These findings have important policy implications for health care reform efforts currently underway in China focusing on how to reduce the burden of catastrophic disease for its citizens.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Lu J,Xu A,Wang J,Zhang L,Song L,Li R,Zhang S,Zhuang G,Lu Mdoi
10.1186/1472-6963-13-37subject
Has Abstractpub_date
2013-01-31 00:00:00pages
37issn
1472-6963pii
1472-6963-13-37journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2411-0
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:There are few studies comparing pharmaceutical costs and the use of medications between immigrants and the autochthonous population in Spain. The objective of this study is to evaluate whether there are differences in pharmaceutical consumption and expenses between immigrant and Spanish-born populations. ME...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-35
更新日期:2008-02-06 00:00:00
abstract:BACKGROUND:Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-178
更新日期:2011-07-31 00:00:00
abstract:BACKGROUND:Early diagnosis is crucial for the treatment of childhood cancer as it in some cases can prevent progression of disease and improve prognoses. However, childhood cancer can be difficult to diagnose and barriers to early diagnosis are multifactorial. New knowledge about factors influencing the pathway to diag...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05821-2
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare, from a Chinese societal perspective, the projected health benefits, costs, and cost-effectiveness of adding pneumococcal conjugate heptavalent vaccine (PCV-7) to the routine compulsory child immunization schedule. METHODS:A decision-tree model, with data and assumpt...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-56
更新日期:2014-02-07 00:00:00
abstract:BACKGROUND:Prompt Mental Health Care (PMHC) is the Norwegian adaptation of Improving Access to Psychological Therapies (IAPT). Thus far, evaluations of PMHC have mostly focused on the effectiveness, rather than on contextual and implementation processes. Therefore, the objective of this study was to do a process evalua...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05311-5
更新日期:2020-05-19 00:00:00
abstract:BACKGROUND:Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients' perceptions of PCC. Fu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05770-w
更新日期:2020-10-20 00:00:00
abstract:BACKGROUND:The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist care, particularly those gen...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-4-8
更新日期:2004-05-13 00:00:00
abstract:BACKGROUND:Having a tax-funded and supposedly 'National' Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth. MAIN BODY:This p...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-019-4790-x
更新日期:2019-12-21 00:00:00
abstract:BACKGROUND:Massive efforts in Canada have been made to renew primary healthcare. However, although early evaluations of initiatives and research on certain aspects of the reform are promising, none have examined the link between patient assessments of care and health outcomes or the impacts at a population level. The g...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-258
更新日期:2010-09-03 00:00:00
abstract:BACKGROUND:Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare. METHODS:This paper presents design and methods of the study "Effectiveness and Cost-Effectiveness of Needs-Oriented Discharge Planning and Monitoring for High Utilisers of P...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-8-152
更新日期:2008-07-21 00:00:00
abstract:BACKGROUND:The healthcare industry is characterized by intensive, never-ending change occurring on a multitude of fronts. Success in such tumultuous environments requires healthcare providers to be proficient in myriad areas, including the manner in which they organize and deliver services. Less efficient designs drain...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2341-x
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:Despite widespread documentation of racial/ethnic disparities in care (predominantly under-use of needed care), differences in population-wide attitudes or experiences about under- or overuse (care where harms may outweigh potential benefits) of care are not well understood. We examined whether race/ethnicit...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1106-7
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:While much research has been conducted on medication safety, few of these studies have addressed primary care, despite the high volume of prescribing and dispensing of medicines that occurs in this setting. Those studies that have examined primary care dispensing emphasised the need to understand the role of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-158
更新日期:2009-09-07 00:00:00
abstract:BACKGROUND:Antimicrobial resistance (AMR) is a prominent threat to public health. Although many guidelines have been developed over the years to tackle this issue, their impact on health care practice varies. Guidelines are often based on evidence from clinical trials, but these have limitations, particularly in the br...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4787-5
更新日期:2019-12-05 00:00:00
abstract:BACKGROUND:We conducted a national level assessment of the quality of clinical care practice in the Ukrainian healthcare system for two important causes of death and chronic disease conditions. We tested two hypotheses: a) quality of care is predicted by physician and facility characteristics and b) health status is pr...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-446
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Primary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-392
更新日期:2012-11-13 00:00:00
abstract:BACKGROUND:Due to rising health care costs, in 2012 Switzerland introduced SwissDRG, a reimbursement system for hospitals based on lump sum per case. To circumvent possible negative consequences like reduction in length of stay, acute and transitional care (ATC) was anchored into the law (Federal act on health insuranc...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05547-1
更新日期:2020-08-03 00:00:00
abstract:BACKGROUND:Duchenne muscular dystrophy (DMD) is the most commonly inherited neuromuscular disease. Therapeutic agents for the treatment of rare disease, namely "orphan drugs", have recently drawn the attention of researchers and pharmaceutical companies. To ensure the successful conduction of clinical trials to evaluat...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1477-4
更新日期:2016-07-11 00:00:00
abstract:BACKGROUND:Determining the optimal number of hospital beds is a complex and challenging endeavor and requires models and techniques which are sensitive to the multi-level, uncertain, and dynamic variables involved. This study identifies and characterizes extant models and methods that can be used to determine the requi...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-5023-z
更新日期:2020-03-06 00:00:00
abstract:BACKGROUND:For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indi...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3764-8
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Crowding in hospital Emergency Departments (EDs) is a problem in several countries. We evaluated the number and characteristics of patients who make repeated visits to the EDs in Naples, Italy. METHODS:All patients (> or = 16 years) who presented to the EDs of three randomly selected non-academic acute care...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-97
更新日期:2008-05-02 00:00:00
abstract:BACKGROUND:Access to healthcare in remote areas is difficult and telehealth could be a promising avenue if accepted by the population. The aim of this study is to assess social acceptance and population confidence in telehealth in the Province of Quebec. METHODS:We conducted a survey using a questionnaire assessing th...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0727-1
更新日期:2015-02-21 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) of the knee is the second most common MRI examination in Norway after head/brain MRI. Little has been published internationally on trends in the use of knee MRI after 1999. This study aimed to describe levels and trends in ambulant knee MRI utilisation in Norway 2002-2004 in ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-115
更新日期:2007-07-22 00:00:00
abstract:BACKGROUND:In the organization of health care and health care systems, there is an increasing trend towards integrated care. Policy-makers from different countries are creating policies intended to promote cooperation and collaboration between health care providers, while facilitating the integration of different healt...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-4950-z
更新日期:2020-02-21 00:00:00
abstract:BACKGROUND:Wellbeing of healthcare workers is important for the effective functioning of health systems. The aim of this study was to explore the conceptualisations of wellbeing, stress and burnout among healthcare workers in primary healthcare settings in rural Ethiopia in order to inform the development of contextual...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2370-5
更新日期:2017-06-19 00:00:00
abstract:BACKGROUND:Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-420
更新日期:2013-10-18 00:00:00
abstract:BACKGROUND:Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innov...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-150
更新日期:2010-06-02 00:00:00
abstract:BACKGROUND:Assessing client and patient satisfaction towards a service is of programmatic importance. A study was conducted in Malawi between July and October 2013 to assess client satisfaction among women who had been screened for cervical cancer using Visual Inspection with Acetic acid test. METHODS:This was a cross...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-420
更新日期:2014-09-22 00:00:00
abstract:BACKGROUND:To evaluate the extent of the difference in elective (ELCS) and emergency (EMCS) caesarean section (CS) rates between nulliparous women in public maternity hospitals in Ireland by model of care, and to quantify the contribution of maternal, clinical, and hospital characteristics in explaining the difference ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1494-3
更新日期:2016-07-08 00:00:00