The Household Economic Burden of Non-Communicable Diseases in 18 Countries

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The Household Economic Burden of Non-Communicable Diseases in 18 Countries Publisher

Murphy A¹ ; Palafox B¹ ; Walliattaei M² ; Powelljackson T¹ ; Rangarajan S² ; Alhabib KF³ ; Avezum AJ⁴ ; Calik KBT⁵ ; Chifamba J⁶ ; Choudhury T⁷ ; Dagenais G⁸ ; Dans AL⁹ ; Gupta R¹⁰ ; Iqbal R¹¹ Show All Authors

Murphy A¹
Palafox B¹
Walliattaei M²
Powelljackson T¹
Rangarajan S²
Alhabib KF³
Avezum AJ⁴
Calik KBT⁵
Chifamba J⁶
Choudhury T⁷
Dagenais G⁸
Dans AL⁹
Gupta R¹⁰
Iqbal R¹¹
Kaur M¹²
Kelishadi R¹³
Khatib R¹⁴
Kruger IM¹⁵
Kutty VR¹⁶
Lear SA¹⁷
Li W¹⁸
Lopezjaramillo P¹⁹
Mohan V²⁰
Mony PK²¹
Orlandini A²²
Rosengren A²³
Rosnah I²⁴
Seron P²⁵
Teo K²
Tse LA²⁶
Tsolekile L²⁷
Wang Y²⁸
Wielgosz A²⁹
Yan R²⁸
Yeates KE³⁰
Yusoff K³¹
Zatonska K³²
Hanson K¹
Yusuf S²
Mckee M¹

Show Affiliations

1. London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, United Kingdom
2. Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
3. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
4. Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
5. Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkiye
6. Department of Physiology, University of Zimbabwe, Harare, Zimbabwe
7. Independent University, Dhaka, Bangladesh
8. Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec City, ON, Canada
9. Department of Medicine, University of the Philippines Manila, Manila, Philippines
10. Eternal Heart Care Centre and Research Institute, Jaipur, India
11. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
12. School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
13. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
14. Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
15. Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa
16. Health Action by People, Trivandrum, Kerala, India
17. Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
18. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, University Teknologi MARA, Beijing, China
19. FOSCAL, Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia
20. Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
21. St John's Medical College and Research Institute, Bangalore, India
22. ECLA Foundation, Santa Fe, Argentina
23. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University, Gothenburg, Sweden
24. Community Health Department, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia
25. Facultad de Medicina, Universidad de la Frontera, Temucu, Chile
26. JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
27. School of Public Health, University of the Western Cape, Bellville, Western Cape, South Africa
28. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
29. Department of Medicine, University of Ottawa, Ottawa, ON, Canada
30. Department of Medicine, Queen's University, Kingston, NH, Canada
31. UiTM Selayang, Selangor, UCSI University, Cheras, Kuala Lumpur, Malaysia
32. Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland

Source: BMJ Global Health Published:2020

Abstract

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. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

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Style	Citing Format
MLA	Murphy A, et al.. "The Household Economic Burden of Non-Communicable Diseases in 18 Countries." BMJ Global Health, vol. 5, no. 2, 2020, pp. -.
APA	Murphy A, Palafox B, Walliattaei M, Powelljackson T, Rangarajan S, Alhabib KF, Avezum AJ, Calik KBT, Chifamba J, Choudhury T, Dagenais G, Dans AL, Gupta R, Iqbal R, Kaur M, Kelishadi R, Khatib R, Kruger IM, Kutty VR, ... Mckee M (2020). The Household Economic Burden of Non-Communicable Diseases in 18 Countries. BMJ Global Health, 5(2), -.
Chicago	Murphy A, Palafox B, Walliattaei M, Powelljackson T, Rangarajan S, Alhabib KF, Avezum AJ, et al.. "The Household Economic Burden of Non-Communicable Diseases in 18 Countries." BMJ Global Health 5, no. 2 (2020): -.
Harvard	Murphy A et al. (2020) 'The Household Economic Burden of Non-Communicable Diseases in 18 Countries', BMJ Global Health, 5(2), pp. -.
Vancouver	Murphy A, Palafox B, Walliattaei M, Powelljackson T, Rangarajan S, Alhabib KF, et al.. The Household Economic Burden of Non-Communicable Diseases in 18 Countries. BMJ Global Health. 2020;5(2):-.
BibTex	@article{ author = {Murphy A and Palafox B and Walliattaei M and Powelljackson T and Rangarajan S and Alhabib KF and Avezum AJ and Calik KBT and Chifamba J and Choudhury T and Dagenais G and Dans AL and Gupta R and Iqbal R and Kaur M and Kelishadi R and Khatib R and Kruger IM and Kutty VR and Lear SA and Li W and Lopezjaramillo P and Mohan V and Mony PK and Orlandini A and Rosengren A and Rosnah I and Seron P and Teo K and Tse LA and Tsolekile L and Wang Y and Wielgosz A and Yan R and Yeates KE and Yusoff K and Zatonska K and Hanson K and Yusuf S and Mckee M}, title = {The Household Economic Burden of Non-Communicable Diseases in 18 Countries}, journal = {BMJ Global Health}, volume = {5}, number = {2}, pages = {-}, year = {2020} }
RIS	TY - JOUR AU - Murphy A AU - Palafox B AU - Walliattaei M AU - Powelljackson T AU - Rangarajan S AU - Alhabib KF AU - Avezum AJ AU - Calik KBT AU - Chifamba J AU - Choudhury T AU - Dagenais G AU - Dans AL AU - Gupta R AU - Iqbal R AU - Kaur M AU - Kelishadi R AU - Khatib R AU - Kruger IM AU - Kutty VR AU - Lear SA AU - Li W AU - Lopezjaramillo P AU - Mohan V AU - Mony PK AU - Orlandini A AU - Rosengren A AU - Rosnah I AU - Seron P AU - Teo K AU - Tse LA AU - Tsolekile L AU - Wang Y AU - Wielgosz A AU - Yan R AU - Yeates KE AU - Yusoff K AU - Zatonska K AU - Hanson K AU - Yusuf S AU - Mckee M TI - The Household Economic Burden of Non-Communicable Diseases in 18 Countries JO - BMJ Global Health VL - 5 IS - 2 SP - EP - PY - 2020 ER -

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