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

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dc.contributor.authorMurphy, Adrianna
dc.contributor.authorPalafox, Benjamin
dc.contributor.authorWalli-Attaei, Marjan
dc.contributor.authorPowell-Jackson, Timothy
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorAlhabib, Khalid F.
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorTumerdem Calik, Kevser Burcu
dc.contributor.authorChifamba, Jephat
dc.contributor.authorChoudhury, Tarzia
dc.contributor.authorDagenais, Gilles
dc.contributor.authorDans, Antonio
dc.contributor.authorGupta, Rajeev
dc.contributor.authorIqbal, Romaina
dc.contributor.authorKaur, Manmeet
dc.contributor.authorKelishadi, Roya
dc.contributor.authorKhatib, Rasha
dc.contributor.authorKruger, Iolanthe Marike
dc.contributor.authorRaman Kutty, Vellappillil
dc.contributor.authorLear, Scott A.
dc.contributor.authorLi, Wei
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorMohan, Viswanathan
dc.contributor.authorMony, Prem K.
dc.contributor.authorOrlandin, Andres
dc.contributor.authorRosengren, Annika
dc.contributor.authorRosnah, Ismail
dc.contributor.authorSeron, Pamela
dc.contributor.authorTeo, Koon
dc.contributor.authorTse, Lap Ah
dc.contributor.authorTsolekile, Lungiswa
dc.contributor.authorWang, Yang
dc.contributor.authorWielgosz, Andreas
dc.contributor.authorYan, Ruohua
dc.contributor.authorYeates, Karen
dc.contributor.authorYusoff, Khalid
dc.contributor.authorZatonska, Katarzyna
dc.contributor.authorHanson, Kara
dc.contributor.authorYusuf, Salim
dc.contributor.authorMcKee, Martin
dc.contributor.researchgroupEverestspa
dc.date.accessioned2021-11-23T22:54:22Z
dc.date.available2021-11-23T22:54:22Z
dc.date.issued2020-02-11
dc.descriptionDigitalspa
dc.description.abstractAbstract Background 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 in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs.eng
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent13 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1136/ bmjgh-2019-002040
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/5727
dc.language.isoengspa
dc.publisherBMJ Global Healthspa
dc.publisher.placeAustraliaspa
dc.relation.citationvolume5spa
dc.relation.citesMurphy A, et al. BMJ Global Health 2020;5:e002040. doi:10.1136/bmjgh-2019-002040
dc.relation.indexedScopusspa
dc.relation.ispartofjournalBMJ Global Healthspa
dc.rights© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://gh.bmj.com/content/bmjgh/5/2/e002040.full.pdfspa
dc.titleThe household economic burden of non-communicable diseases in 18 countriesspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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