Objectives: Financial risk protection (FRP), or the prevention of medical impoverishment, is a major objective of health systems, particularly in low- and middle-income countries where the extent of out-of-pocket (OOP) health expenditures can be substantial. We sought to develop a method that allows decision makers to explicitly integrate FRP outcomes into their priority-setting activities.
Methods: We used literature review to identify 31 interventions in low- and middle-income countries, each of which provided measures of health outcomes, costs, OOP health expenditures averted, and FRP (proxied by OOP health expenditures averted as a percentage of income), all disaggregated by income quintile. We developed weights drawn from the Z-score of each quintile-intervention pair based on the distribution of FRP of all quintile-intervention pairs. We next ranked the interventions by unweighted and weighted health outcomes for each income quintile. We also evaluated how pro-poor they were by, first, ordering the interventions by cost-effectiveness for each quintile and, next, calculating the proportion of interventions each income quintile would be targeted for a given random budget. A ranking was said to be pro-poor if each quintile received the same or higher proportion of interventions than richer quintiles.
Results: Using FRP weights produced a more pro-poor priority setting than unweighted outcomes. Most of the reordering produced by the inclusion of FRP weights occurred in interventions of moderate cost-effectiveness, suggesting that these weights would be most useful as a way of distinguishing moderately cost-effective interventions with relatively high potential FRP.
Conclusions: This preliminary method of integrating FRP into priority-setting would likely be most suitable to deciding between health interventions with intermediate cost-effectiveness.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jval.2022.09.007 | DOI Listing |
Int J Equity Health
January 2025
Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: The severe health challenge and financial burden of drug-resistant tuberculosis (DR-TB) continues to be an impediment in China and worldwide. This study aimed to explore the impact of Diagnosis-related group (DRG) payment on medical expenditure and treatment efficiency among DR-TB patients.
Methods: This retrospective cohort study included all DR-TB patients from the digitized Hospital Information System (HIS) of Wuhan Pulmonary Hospital and the TB Information Management System (TBIMS) with completed full course of National Tuberculosis Program (NTP) standard treatment in Wuhan from January 2016 to December 2022, excluding patients whose treatment spanned both before and after the DRG timepoint.
Am J Manag Care
December 2024
Johns Hopkins Hospital, 1305 Dock St, Apt 310, Baltimore, MD 21231. Email:
Objectives: Although cardiac rehabilitation (CR) improves cardiovascular outcomes, adherence remains low. Higher patient-incurred out-of-pocket (OOP) spending may be a barrier to CR adherence. We evaluated the association between OOP spending for the first CR session and adherence.
View Article and Find Full Text PDFInquiry
December 2024
Department of Economics, University of Kashmir, Srinagar, India.
This study investigates the relationship between out-of-pocket (OOP) healthcare spending, economic growth, population growth, and government health expenditure as a proportion of general government expenditure using National Health Accounts (NHA) estimates. Out-of-Pocket (OOP) healthcare spending imposes a substantial financial burden on households, especially in developing economies such as India. Understanding the factors that influence OOP payments is crucial for policymakers seeking to enhance healthcare systems and achieve Universal Health Coverage (UHC).
View Article and Find Full Text PDFAm J Surg
December 2024
Department of Surgery, Northwestern University Feinberg School of Medicine, USA.
Background: Nearly a billion people worldwide risk Financial Catastrophe (FC) due to Out-of-Pocket (OOP) health expenditures. With Low-and-Middle-Income Countries (LMICs) disproportionately impacted, and the global burden of colorectal cancer (CRC) expected to increase 60 % by 2030, Nigeria is of interest. This study aims to evaluate the cost of treating CRC at Nigeria's first private cancer center.
View Article and Find Full Text PDFJ Educ Health Promot
October 2024
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!