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A Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries

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Listed:
  • Mark D Huffman
  • Krishna D Rao
  • Andres Pichon-Riviere
  • Dong Zhao
  • S Harikrishnan
  • Kaushik Ramaiya
  • V S Ajay
  • Shifalika Goenka
  • Juan I Calcagno
  • Joaquín E Caporale
  • Shaoli Niu
  • Yan Li
  • Jing Liu
  • K R Thankappan
  • Meena Daivadanam
  • Jan van Esch
  • Adrianna Murphy
  • Andrew E Moran
  • Thomas A Gaziano
  • Marc Suhrcke
  • K Srinath Reddy
  • Stephen Leeder
  • Dorairaj Prabhakaran

Abstract

Objective: To estimate individual and household economic impact of cardiovascular disease (CVD) in selected low- and middle-income countries (LMIC). Background: Empirical evidence on the microeconomic consequences of CVD in LMIC is scarce. Methods and Findings: We surveyed 1,657 recently hospitalized CVD patients (66% male; mean age 55.8 years) from Argentina, China, India, and Tanzania to evaluate the microeconomic and functional/productivity impact of CVD hospitalization. Respondents were stratified into three income groups. Median out-of-pocket expenditures for CVD treatment over 15 month follow-up ranged from 354 international dollars (2007 INT$, Tanzania, low-income) to INT$2,917 (India, high-income). Catastrophic health spending (CHS) was present in >50% of respondents in China, India, and Tanzania. Distress financing (DF) and lost income were more common in low-income respondents. After adjustment, lack of health insurance was associated with CHS in Argentina (OR 4.73 [2.56, 8.76], India (OR 3.93 [2.23, 6.90], and Tanzania (OR 3.68 [1.86, 7.26] with a marginal association in China (OR 2.05 [0.82, 5.11]). These economic effects were accompanied by substantial decreases in individual functional health and productivity. Conclusions: Individuals in selected LMIC bear significant financial burdens following CVD hospitalization, yet with substantial variation across and within countries. Lack of insurance may drive much of the financial stress of CVD in LMIC patients and their families.

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  • Mark D Huffman & Krishna D Rao & Andres Pichon-Riviere & Dong Zhao & S Harikrishnan & Kaushik Ramaiya & V S Ajay & Shifalika Goenka & Juan I Calcagno & Joaquín E Caporale & Shaoli Niu & Yan Li & Jing , 2011. "A Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-10, June.
    • Handle: RePEc:plo:pone00:0020821
    DOI: 10.1371/journal.pone.0020821
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    References listed on IDEAS

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    2. Shankar Prinja & Jagnoor Jagnoor & Akashdeep Singh Chauhan & Sameer Aggarwal & Ha Nguyen & Rebecca Ivers, 2016. "Economic Burden of Hospitalization Due to Injuries in North India: A Cohort Study," IJERPH, MDPI, vol. 13(7), pages 1-15, July.
    3. Eric A Finkelstein & Junxing Chay & Shailendra Bajpai, 2014. "The Economic Burden of Self-Reported and Undiagnosed Cardiovascular Diseases and Diabetes on Indonesian Households," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    4. Shankar Prinja & Yashpaul Sharma & Jyoti Dixit & Shyam Kumar Singh Thingnam & Rajesh Kumar, 2019. "Cost of Treatment of Valvular Heart Disease at a Tertiary Hospital in North India: Policy Implications," PharmacoEconomics - Open, Springer, vol. 3(3), pages 391-402, September.

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