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The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients

INTRODUCTION: Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide, and their prevalence in lower- and middle-income countries (LMIC) is on the rise. The burden of chronic health expenditure born by patient households in these countries may be very high, particula...

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Autores principales: Murphy, Adrianna, Mahal, Ajay, Richardson, Erica, Moran, Andrew E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691525/
https://www.ncbi.nlm.nih.gov/pubmed/23718769
http://dx.doi.org/10.1186/1475-9276-12-38
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author Murphy, Adrianna
Mahal, Ajay
Richardson, Erica
Moran, Andrew E
author_facet Murphy, Adrianna
Mahal, Ajay
Richardson, Erica
Moran, Andrew E
author_sort Murphy, Adrianna
collection PubMed
description INTRODUCTION: Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide, and their prevalence in lower- and middle-income countries (LMIC) is on the rise. The burden of chronic health expenditure born by patient households in these countries may be very high, particularly where out-of-pocket payments for health care are common. One such country where out-of-pocket payments are especially high is Ukraine. The financial impact of NCDs on households in this country has not been researched. METHODS: We set out to explore the burden of NCD care in Ukraine with a study of angina patients. Using data from the Ukraine World Health Survey of 2003 we employed the novel Coarsened Exact Matching approach to estimate the difference in out-of-pocket payment (OPP) for health care between households with a stable angina pectoris (a chronic form of IHD) patient and those without. The likelihood of engaging in catastrophic spending and using various distress financing mechanisms (e.g. sale of assets, borrowing) among angina households compared with non-angina households was also explored. RESULTS: Among angina patient households (n = 203), OPP occupied an average of 32% of household effective income. After matching, angina households experienced significantly higher monthly per capita OPP for health care (B = $2.84) and medicines (B = $2.94), but were not at significantly higher odds of engaging in catastrophic spending. Odds of engaging in ‘sale of assets’ (OR = 2.71) and ‘borrowing’ (OR = 1.68) to finance OPP were significantly higher among angina households. CONCLUSIONS: The cost of chronic care in Ukraine places a burden on individual patient households. Households of angina patients are more likely to engage in distress financing to cover the cost of treatment, and a high proportion of patients do not acquire prescribed medicines because they cannot afford them. This warrants further research on the burden of NCD care in other LMIC, especially where OPP for health care is common. Health policies aimed at reducing OPP for health care, and especially medicines, would lessen the high health and financial burden of chronic care. Further research is also needed on the long-term impact of borrowing or sale of assets to finance OPP on patient households.
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spelling pubmed-36915252013-06-26 The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients Murphy, Adrianna Mahal, Ajay Richardson, Erica Moran, Andrew E Int J Equity Health Research INTRODUCTION: Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide, and their prevalence in lower- and middle-income countries (LMIC) is on the rise. The burden of chronic health expenditure born by patient households in these countries may be very high, particularly where out-of-pocket payments for health care are common. One such country where out-of-pocket payments are especially high is Ukraine. The financial impact of NCDs on households in this country has not been researched. METHODS: We set out to explore the burden of NCD care in Ukraine with a study of angina patients. Using data from the Ukraine World Health Survey of 2003 we employed the novel Coarsened Exact Matching approach to estimate the difference in out-of-pocket payment (OPP) for health care between households with a stable angina pectoris (a chronic form of IHD) patient and those without. The likelihood of engaging in catastrophic spending and using various distress financing mechanisms (e.g. sale of assets, borrowing) among angina households compared with non-angina households was also explored. RESULTS: Among angina patient households (n = 203), OPP occupied an average of 32% of household effective income. After matching, angina households experienced significantly higher monthly per capita OPP for health care (B = $2.84) and medicines (B = $2.94), but were not at significantly higher odds of engaging in catastrophic spending. Odds of engaging in ‘sale of assets’ (OR = 2.71) and ‘borrowing’ (OR = 1.68) to finance OPP were significantly higher among angina households. CONCLUSIONS: The cost of chronic care in Ukraine places a burden on individual patient households. Households of angina patients are more likely to engage in distress financing to cover the cost of treatment, and a high proportion of patients do not acquire prescribed medicines because they cannot afford them. This warrants further research on the burden of NCD care in other LMIC, especially where OPP for health care is common. Health policies aimed at reducing OPP for health care, and especially medicines, would lessen the high health and financial burden of chronic care. Further research is also needed on the long-term impact of borrowing or sale of assets to finance OPP on patient households. BioMed Central 2013-05-30 /pmc/articles/PMC3691525/ /pubmed/23718769 http://dx.doi.org/10.1186/1475-9276-12-38 Text en Copyright © 2013 Murphy et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Murphy, Adrianna
Mahal, Ajay
Richardson, Erica
Moran, Andrew E
The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title_full The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title_fullStr The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title_full_unstemmed The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title_short The economic burden of chronic disease care faced by households in Ukraine: a cross-sectional matching study of angina patients
title_sort economic burden of chronic disease care faced by households in ukraine: a cross-sectional matching study of angina patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691525/
https://www.ncbi.nlm.nih.gov/pubmed/23718769
http://dx.doi.org/10.1186/1475-9276-12-38
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