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NTU 620 HEPI Lab
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Team Members
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AI and Machine learning
Physical-mental multimorbidity
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Chronic condition in Singapore
Cost effectiveness analysis of intervention
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Quality of care in India
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Minority health
Reproductive, Maternal, and Child health
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Out-of-pocket expenditure for medicine
Disability and Multimorbidity
Innovative Health Financing
Health system performance evaluation
Multimorbidity and comorbidity
Indonesia Health system reform and JKN
User fee and patient cost sharing
Economic recession and health
Economics of Tobacco
Cancer screening
Media Coverage
Educational Program
NTU 620 HEPI Lab
Home
Team Members
Research Grant
Publications
Research Projects
AI and Machine learning
Physical-mental multimorbidity
Economics of Multimorbidity
Chronic condition in Singapore
Cost effectiveness analysis of intervention
Pay-for-performance
NHS Health checks
Health Workforce Planning Model
Quality of care in India
Other Research Projects
Minority health
Reproductive, Maternal, and Child health
Physical Activitiyes
Out-of-pocket expenditure for medicine
Disability and Multimorbidity
Innovative Health Financing
Health system performance evaluation
Multimorbidity and comorbidity
Indonesia Health system reform and JKN
User fee and patient cost sharing
Economic recession and health
Economics of Tobacco
Cancer screening
Media Coverage
Educational Program
More
Home
Team Members
Research Grant
Publications
Research Projects
AI and Machine learning
Physical-mental multimorbidity
Economics of Multimorbidity
Chronic condition in Singapore
Cost effectiveness analysis of intervention
Pay-for-performance
NHS Health checks
Health Workforce Planning Model
Quality of care in India
Other Research Projects
Minority health
Reproductive, Maternal, and Child health
Physical Activitiyes
Out-of-pocket expenditure for medicine
Disability and Multimorbidity
Innovative Health Financing
Health system performance evaluation
Multimorbidity and comorbidity
Indonesia Health system reform and JKN
User fee and patient cost sharing
Economic recession and health
Economics of Tobacco
Cancer screening
Media Coverage
Educational Program
Out-of-pocket expenditure for medicine
Frontiers | Multimorbidity and out-of-pocket expenditure on medicine in Europe: Longitudinal analysis of 13 European countries between 2013 and 2015
BackgroundMany European Health Systems are implementing or increasing levels of cost-sharing for medicine in response to the growing constrains on public spe...
Multimorbidity and out-of-pocket expenditure on medicines: a systematic review
Background Multimorbidity, the presence of two or more non-communicable diseases (NCD), is a costly and complex challenge for health systems globally. Patients with NCDs incur high levels of out-of-pocket expenditure (OOPE), often on medicines, but the literature on the association between OOPE on medicines and multimorbidity has not been examined systematically.Methods A systematic review was conducted via searching medical and economics databases including Ovid Medline, EMBASE, EconLit, Cochrane Library and the WHO Global Health Library from year 2000 to 2016. Study quality was assessed using Newcastle-Ottawa Scale. PROSPERO: CRD42016053538.Findings 14 articles met inclusion criteria. Findings indicated that multimorbidity was associated with higher OOPE on medicines. When number of NCDs increased from 0 to 1, 2 and ≥3, annual OOPE on medicines increased by an average of 2.7 times, 5.2 times and 10.1 times, respectively. When number of NCDs increased from 0 to 1, 2, ≥2 and ≥3, individuals spent a median of 0.36% (IQR 0.15%–0.51%), 1.15% (IQR 0.62%–1.64%), 1.41% (IQR 0.86%–2.15%), 2.42% (IQR 2.05%–2.64%) and 2.63% (IQR 1.56%–4.13%) of mean annual household net adjusted disposable income per capita, respectively, on annual OOPE on medicines. More multimorbidities were associated with higher OOPE on medicines as a proportion of total healthcare expenditures by patients. Some evidence suggested that the elderly and low-income groups were most vulnerable to higher OOPE on medicines. With the same number of NCDs, certain combinations of NCDs yielded higher medicine OOPE. Non-adherence to medicines was a coping strategy for OOPE on medicines.Conclusion Multimorbidity of NCDs is increasingly costly to healthcare systems and OOPE on medicines can severely compromise financial protection and universal health coverage. It is crucial to recognise the need for better equity and financial protection, and policymakers should consider health system financial options, cost sharing policies and service patterns for those with NCD multimorbidities.
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