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The household economic burden of non-communicable diseases in 18 countries

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dc.contributor.authorÇALIK, KEVSER BURCU
dc.contributor.authorsMurphy, Adrianna; Palafox, Benjamin; Walli-Attaei, Marjan; Powell-Jackson, Timothy; Rangarajan, Sumathy; Alhabib, Khalid F.; Avezum, Alvaro Jr; Calik, Kevser Burcu Tumerdem; Chifamba, Jephat; Choudhury, Tarzia; Dagenais, Gilles; Dans, Antonio L.; Gupta, Rajeev; Iqbal, Romaina; Kaur, Manmeet; Kelishadi, Roya; Khatib, Rasha; Kruger, Iolanthe Marike; Kutty, Vellappillil Raman; Lear, Scott A.; Li, Wei; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Mony, Prem K.; Orlandini, Andres; Rosengren, Annika; Rosnah, Ismail; Seron, Pamela; Teo, Koon; Tse, Lap Ah; Tsolekile, Lungiswa; Wang, Yang; Wielgosz, Andreas; Yan, Ruohua; Yeates, Karen E.; Yusoff, Khalid; Zatonska, Katarzyna; Hanson, Kara; Yusuf, Salim; Mckee, Martin
dc.date.accessioned2022-03-14T09:32:00Z
dc.date.available2022-03-14T09:32:00Z
dc.date.issued2020-02
dc.description.abstractBackground Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. Methods Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China. Results The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs. Conclusions Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden
dc.identifier.doi10.1136/bmjgh-2019-002040
dc.identifier.issn2059-7908
dc.identifier.pubmed32133191
dc.identifier.urihttps://hdl.handle.net/11424/243234
dc.identifier.wosWOS:000527707600013
dc.language.isoeng
dc.publisherBMJ PUBLISHING GROUP
dc.relation.ispartofBMJ GLOBAL HEALTH
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMIDDLE-INCOME
dc.subjectHEALTH-CARE
dc.subjectCARDIOVASCULAR-DISEASE
dc.subjectSECONDARY PREVENTION
dc.subjectSOCIOECONOMIC-STATUS
dc.subjectPURE
dc.subjectAFFORDABILITY
dc.subjectAVAILABILITY
dc.subjectHYPERTENSION
dc.titleThe household economic burden of non-communicable diseases in 18 countries
dc.typearticle
dspace.entity.typePublication
local.avesis.id11c5f280-677c-481b-8ece-56a9c79b662c
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.articlenumbere002040
local.journal.numberofpages13
local.journal.quartileQ1
oaire.citation.issue2
oaire.citation.titleBMJ GLOBAL HEALTH
oaire.citation.volume5
relation.isAuthorOfPublication5d2197da-8f32-4802-802a-282a96cbf59e
relation.isAuthorOfPublication.latestForDiscovery5d2197da-8f32-4802-802a-282a96cbf59e

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