Health Economics Review最新文献

Objectives: Our main objective is to measure the economic impact of managing diabetes-related visual impairment and blindness in the Kingdom of Saudi Arabia (KSA) to inform policy and resource allocation for effective disease management and prevention.

Methods: We develop a prevalence-based cost of illness model using Microsoft Excel to assess the economic impact of treating diabetic-related visual impairment and blindness over a one-year period from societal perspective. The model categorizes costs according to the severity level of the condition: mild, moderate, and severe visual impairment and blindness. It encompasses direct medical expenses such as those for drug acquisitions, surgical procedures, healthcare resources, monitoring, visual aids, and psychological care, as well as indirect costs such as productivity losses in the financial year 2024. The model's outputs provide a cumulative and detailed breakdown of the costs associated with visual impairment and blindness in KSA. Sensitivity analysis was conducted.

Results: Our economic model shows that the total economic burden of diabetes-related visual impairment and blindness in KSA in one year is SAR 150,324,912,186 ($ 81.2 billion). This cost is divided into direct and indirect medical costs estimated at SAR 101 billion ($ 54.6 billion) and SAR 49 billion ($26.5 billion), respectively. The major component is medication costs, along with patients' productivity loss.

Conclusion: The significant economic repercussions of diabetes-related visual impairment and blindness across individuals, households, and the Saudi healthcare system impose a substantial financial burden. These findings highlight the urgent need for investment in innovative interventions and screening programs aimed at mitigating these costs, enhancing accessibility to essential treatments, improving the quality of life of affected individuals and families, and achieving sustainable healthcare and socioeconomic development goals in the Kingdom.

Background: Congenital anomalies represent a major cause of childhood morbidity and disability, imposing long-term health, social, and financial challenges. While medical expenditures are relatively well-documented, evidence on the broader financial and social impact on families-particularly in Central and Eastern Europe-remains limited. Accordingly, this study aimed to quantify the economic burden associated with congenital anomalies from a caregiver perspective.

Methods: A cross-sectional, questionnaire-based study was conducted in Lithuania in 2023 among 160 caregivers of children aged 5-18 years diagnosed with congenital anomalies. Participants were grouped by the number of affected organ systems to reflect the increasing disease complexity. Using standardized cost-of-illness methodology and both the human capital and opportunity cost approaches, we estimated annual direct medical and non-medical, indirect, and informal care costs.

Results: Families experienced a substantial and multidimensional financial burden that intensified with disease severity. The annual indirect cost, mainly reflecting productivity losses, represented the largest component of the total economic burden, with a median of €7,566 overall and €12,965 in the most severely affected families. Out-of-pocket payments were also considerable, with a median of €2,040 per year; in the most severe group they exceeded 20% of monthly household income for 42% of families. The economic value of informal care represented a smaller yet meaningful portion of total costs (median €1,967), increasing more than fivefold between the mildest and most severe groups.

Conclusions: Congenital anomalies place a substantial economic burden on families, extending far beyond healthcare expenses. These findings highlight the need for policies that improve financial protection, support caregivers' labor market participation, and acknowledge the economic value of informal care within health and welfare systems.

Background: Mental health conditions impose substantial economic burdens on healthcare systems globally, with growing evidence indicating disproportionate impacts on household-level out-of-pocket (OOP) expenditures. Despite Australia's universal healthcare system, the financial burden of mental health conditions on households remains underexplored.

Objective: To examine the longitudinal relationship between mental health status and OOP healthcare expenditures among Australian adults, and assess how education and income moderate this relationship.

Methods: We analyzed 17 waves (2006-2022) of the Household, Income and Labour Dynamics in Australia (HILDA) survey, encompassing 57,647 person-year observations from 3,391 unique individuals. Mental health was measured using the Mental Health Inventory-5 (MHI-5) scale and newly proposed expanded MHI-9 scales. We employed fixed-effects panel regression models and instrumental variable analysis to address unobserved heterogeneity.

Results: A one-unit decrease in MHI-5 score is associated with 0.18-0.25% increase in inflation-adjusted OOP healthcare expenditure, equivalent to AU$2.10-$3.00 per unit decline, with a 10-point decline in MHI-5 costing households an additional AU$21-$30. Instrumental variable estimates revealed larger causal effects of 0.80-1.00%. Individuals with good mental health and higher education demonstrated expenditure patterns consistent with Grossman's health capital theory, while those with poor mental health showed disrupted relationships between education and healthcare spending. Urban residents faced 11.00% higher inflation-adjusted OOP costs than the rural residents.

Conclusions: Mental health deterioration significantly increases household healthcare expenditure burdens in Australia. Traditional health economics theories apply primarily to individuals with good mental health, indicating the need for targeted rather than universal policy approaches.

Background: The concept of social capital and its association with health has gained relevance in the last decades. Different proposals for its measurement and classification have been established, making the use of a wide range of variables essential for its proper coverage. In this sense, we aim at measuring two dimensions of social capital, bonding and bridging social capital, for the elder European population and how they both relate with self-assessed health. Recent evidence for this population group is missing.

Methods: We used the 2011, 2015, and 2019 waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) to obtain a proper range of variables assessing social capital. Fixed-effects logistic regressions were performed, regressing self-assessed health on social capital variables. We also included lagged values of social capital in our estimations to test temporal dynamics in the relationship between social capital and health, and conducted heterogenous analysis by gender and marital status.

Results: High levels of bridging social capital reduced the odds of declaring a poor health status, even after controlling for socioeconomic characteristics, objective health variables, and year dummies (OR: 0.878 95%CI: 0.82-0.941). Our heterogenous analyses revealed that being satisfied with social networks is correlated with lower odds of reporting poor health among single older adults and females. Additionally, we observed that high values of bridging capital in 2015 were correlated with lower odds of assessing a poor health status in 2019 (OR: 0.928; 95%CI: 0.872-0.987), as were having a larger number of family members in the social network (OR: 0.939; 95%CI: 0.895-0.985) and being satisfied with bridging social capital activities in 2015 (OR: 0.899; 95%CI: 0.851-0.948).

Conclusions: Our results highlight the important role of participating in social activities on European older adults' health across time. Thus, policies aimed at promoting these activities not only might reduce unwanted loneliness among older adults, but also improve their health across time.

Background: China's fast economic growth has been accompanied by rapid urbanization and urban renewal. Millions of households have experienced housing demolition and relocation ("chaiqian") to vacate the land for urban renewal and infrastructure projects. Housing demolition can be a major life disruption and place a considerable burden on both mental and physical health. Meanwhile, replacement housing, provided as compensation for demolition, can improve housing quality and access to care, thus improving health.

Methods: Using data from the China Family Panel Studies and an event study model with a staggered difference-in-differences framework, we examined the effects of housing demolition on individuals' medical utilization in the year of demolition, as well as two and four years afterward. Medical utilization was measured as whether an individual uses medical services (incurring medical expenditure) and the amount of medical expenditure if using medical services. We also explored the effects of housing demolition on health measures, namely self-rated health and mental health status, as potential mechanisms through which housing demolition affects medical utilization.

Results: Overall, housing demolition did not affect whether an individual used medical services. However, conditional on using medical services, housing demolition increased the amount of medical expenditure by approximately 1,639 CNY (234 USD) two years after demolition. We did not find evidence that housing demolition is associated with self-rated health or mental health status. Moreover, we found urban-rural heterogeneity in the effects of housing demolition. Rural residents have a higher likelihood of using medical services and higher medical expenditure two years after demolition, while urban residents have a lower likelihood of using medical services four years after demolition.

Conclusions: Our findings highlight the importance of housing as a social determinant of health and contribute to the growing literature on development-induced displacement. The increased medical expenditure after housing demolition calls for a multidimensional evaluation of compensation for housing demolition. The compensation should consider both the loss of property itself and other associated adverse impacts, such as on health and medical care, to fully offset the burden of housing demolition, especially for rural residents who are particularly vulnerable after housing demolition.