Abstract
INTRODUCTION: Chronic Hepatitis C virus (HCV) infection can incur high out-of-pocket (OOP) health-related expenditure, which may result in impoverishment. METHODS: This study aimed to describe the annual OOP expenditure among patients with various HCV-related disease states (non-cirrhotic chronic infection, compensated cirrhosis, decompensated cirrhosis and liver carcinoma) and the poverty impact following healthcare expenditure. This study was conducted in University Malaya Medical Centre (UMMC) through face-to-face interviews. Data on various household OOP expenditure related to clinical management of HCV disease states were gathered. Poverty impact was calculated as difference in poverty headcount and poverty gap before and after disease-related healthcare expenditures. RESULTS: The mean (SD) annual OOP expenditure for the studied households(n=135) was RM 5892(10405). The highest mean (SD) annual OOP expenditure was by patients with liver carcinoma at RM10172(16041) and the lowest expenditure was by patients with non-cirrhotic chronic HCV infection at RM1811(2504). The four main drivers for OOP expenditures were traditional and complementary medicine, antiviral treatment, clinical procedures and hospitalisation. OOP expenditures caused 18(13.3%) households to experience impoverishment. The income shortfall below the national poverty line was RM7054. DISCUSSION: Patients with advanced HCV-related disease states had higher health-related expenditure compared to those with early disease states, with OOP expenditure leading to impoverishment in a number of households. As this study was conducted in UMMC the charges can be higher than other public hospitals and reflected in the findings. These findings can be useful to inform future policies to minimise the financial impact of chronic HCV disease on the patients and their households.
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@proceedings{APCPH-2019-64,
title = {Household Health-Related Expenditure and Poverty Impact of Chronic Hepatitis C Disease: Evidence from Malaysia},
author = {Amirah Azzeri and Fatiha Hana Shabaruddin and Rosmawati Mohamed and Maznah Dahlui},
year = {2019},
date = {2019-07-22},
urldate = {2019-07-22},
journal = {6th Asia-Pacific Conference on Public Health 2019 Proceedings},
issue = {6},
abstract = {INTRODUCTION: Chronic Hepatitis C virus (HCV) infection can incur high out-of-pocket (OOP) health-related expenditure, which may result in impoverishment. METHODS: This study aimed to describe the annual OOP expenditure among patients with various HCV-related disease states (non-cirrhotic chronic infection, compensated cirrhosis, decompensated cirrhosis and liver carcinoma) and the poverty impact following healthcare expenditure. This study was conducted in University Malaya Medical Centre (UMMC) through face-to-face interviews. Data on various household OOP expenditure related to clinical management of HCV disease states were gathered. Poverty impact was calculated as difference in poverty headcount and poverty gap before and after disease-related healthcare expenditures. RESULTS: The mean (SD) annual OOP expenditure for the studied households(n=135) was RM 5892(10405). The highest mean (SD) annual OOP expenditure was by patients with liver carcinoma at RM10172(16041) and the lowest expenditure was by patients with non-cirrhotic chronic HCV infection at RM1811(2504). The four main drivers for OOP expenditures were traditional and complementary medicine, antiviral treatment, clinical procedures and hospitalisation. OOP expenditures caused 18(13.3%) households to experience impoverishment. The income shortfall below the national poverty line was RM7054. DISCUSSION: Patients with advanced HCV-related disease states had higher health-related expenditure compared to those with early disease states, with OOP expenditure leading to impoverishment in a number of households. As this study was conducted in UMMC the charges can be higher than other public hospitals and reflected in the findings. These findings can be useful to inform future policies to minimise the financial impact of chronic HCV disease on the patients and their households.},
note = {Type: ORAL PRESENTATION; Organisation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia},
keywords = {hepatitis C, household expenditure, Malaysia, Out-of-pocket (OOP), poverty impact},
pubstate = {published},
tppubtype = {proceedings}
}