Financial burden

财政负担
  • 文章类型: Journal Article
    目的:提供迄今为止发布的用于估算运动相关伤害成本的方法的概述,并强调未来研究的考虑因素和机会。
    方法:范围审查。
    方法:Scopus,从2000年1月1日至2023年1月1日搜索了MEDLINE和CINHAL。研究由两名独立的审阅者进行筛选,如果他们报告了与运动相关的伤害的成本分析或成本估算,则符合资格。
    结果:31项研究符合纳入标准。自2014年以来,发表了27项研究(87%)。成本类型包括直接医疗成本(12项研究),间接成本(10项研究)和两者的组合(9项研究)。21项研究(68%)使用自下而上的成本计算方法来衡量运动损伤的成本,并根据卫生系统的服务费率或收费表估算直接成本,医院,保险公司或国家保险委员会。在七项研究(23%)中使用了自上而下的方法,使用来自公开资源的数据估算了时间损失伤害的间接工资成本。十项研究是从体育组织的成本角度进行的(32%)。缺乏对所使用的成本计算方法和承担成本的人的观点的明确报告。
    结论:估计运动损伤的成本是一个新兴的研究领域,随着近年来出版物的增加。然而,仍然缺乏提供信息或评估这些研究的方法学指导。建议扩展已建立的疾病费用清单,并提供运动损伤解释,以指导未来的运动损伤研究费用。
    OBJECTIVE: Provide an overview of the methods used to estimate the cost of sports-related injury published to date, and to highlight considerations and opportunities for future research.
    METHODS: Scoping review.
    METHODS: Scopus, MEDLINE and CINHAL were searched from 1st January 2000 to 1st January 2023. Studies were screened by two independent reviewers and were eligible if they reported on a cost analysis or cost estimation of sports related injury.
    RESULTS: Thirty-one studies fulfilled the inclusion criteria. Twenty-seven studies (87 %) were published since 2014. The type of costs included direct healthcare costs (12 studies), indirect costs (10 studies) and a combination of both (9 studies). Twenty-one studies (68 %) used a bottom-up costing approach to measure costs of sports injury and estimated direct costs from the service rates or fee schedules of health systems, hospital, insurance companies or national insurance boards. A top-down approach was used in seven studies (23 %) to estimate the indirect salary cost of time-loss injuries using data from publicly available resources. Ten studies were from the cost perspective of a sporting organisation (32 %). There was a lack of explicit reporting of the costing method used and the perspective of those bearing the costs.
    CONCLUSIONS: Estimating the cost of sports injuries is an emerging area of research, with publications increasing in recent years. However, there remains a lack of methodological guidance to inform or appraise these studies. The expansion of established cost of illness checklists with sport injury explanations to guide future cost of sports injury studies is recommended.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:骨科损伤和管理会带来大量成本。这些费用在患者中可能并不平等。在医疗保健和医院系统层面,在骨科创伤患者中,已经发现了经济负担和患者人口统计学的差异。因此,差异也可能出现在患者水平以及他们如何体验护理成本。我们试图确定(1)患者的人口统计学如何与经济负担/毒性相关,以及(2)患者是否经历了不成比例的经济负担/毒性和继发于其经济地位的社会支持。
    结果:据描述,在某些社会经济人口统计学中,临床和经济结果存在不公平的经验,导致财政负担的差异。据进一步报道,骨科损伤,管理,结果在所有人口和社会经济群体中都没有得到公平的体验。十篇文章符合纳入标准,其中,在不同年龄的骨科创伤患者中,经济负担不成比例,性别,种族,教育,和婚姻状况。财政困难也在不同的收入水平之间分配不均,employment,保险状况,社会剥夺。年轻,女性,非白色,未婚患者的经济负担增加。受教育程度较低的患者,收入较低,有限或没有保险,与经济地位改善的患者相比,更大的社会剥夺不成比例地经历了经济毒性。进一步调查政策变化,社会支持,应解决适当护理的障碍,以防止不必要的经济负担并促进更大的患者福利。
    OBJECTIVE: There are substantial costs associated with orthopedic injury and management. These costs are likely not experienced equally among patients. At the level of the healthcare and hospital systems, disparities in financial burden and patient demographics have already been identified among orthopedic trauma patients. Accordingly, disparities may also arise at the level of the patient and how they experience the cost of their care. We sought to determine (1) how patient demographics are associated with financial burden/toxicity and (2) if patients experience disproportionate financial burden/toxicity and social support secondary to their economic standing.
    RESULTS: It has been described that there is an inequitable experience in clinical and economic outcomes in certain socioeconomic demographics leading to disparities in financial burden. It has been further reported that orthopedic injury, management, and outcomes are not experienced equitably among all demographic and socioeconomic groups. Ten articles met inclusion criteria, among which financial burden was disproportionately experienced amid orthopedic trauma patients across age, gender, race, education, and marital status. Financial hardship was also unequally distributed among different levels of income, employment, insurance status, and social deprivation. Younger, female, non-White, and unmarried patients experience increased financial burden. Patients with less education, lower income, limited or no insurance, and greater social deprivation disproportionately experienced financial toxicity compared to patients of improved economic standing. Further investigation into policy changes, social support, and barriers to appropriate care should be addressed to prevent unnecessary financial burden and promote greater patient welfare.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    对非正式护理人员的经济负担的兴趣一直在增长。不幸的是,目前尚不清楚量化这一负担时应使用哪种方法.
    我们进行了范围审查,旨在确定哪些方法已用于进行此类工作并量化其性能。我们也有兴趣研究在选定的研究中如何考虑性别和性别因素。
    使用标准化方法,我们确定了2012-2022年间发表的旨在记录儿童和青少年患者照顾者的经济负担的研究.我们的搜索策略被应用于MEDLINE,Embase,CINHAL,和学术搜索Premier数据库。
    手稿选择由成对的审阅者执行。
    数据提取由一个审阅者进行,第二审阅者进行质量控制。使用叙述方法报告结果。
    我们确定了9801个独特的引文,其中200人包括在我们的审查中。选定的研究涵盖了各种疾病领域(例如,感染/寄生虫病[n=31,16%]),包括定量(n=180,90%),定性(n=4,2%)和混合研究设计(n=16,8%)。大多数研究(n=182,91%)使用问卷/调查,单独或与其他方法结合使用,评估护理人员的经济负担。不到一半(n=93,47%)的研究报告了护理人员的性别,没有报告他们的性别。
    我们对已发表的研究进行了无限制的审查,这些研究检查了护理人员的经济负担,使我们能够确定本文献中观察到的一般方法学趋势。我们相信这项工作可能有助于改善未来对这一重要问题的研究。
    UNASSIGNED: Interest in the financial burden of informal caregivers has been growing. Unfortunately, it remains unclear which method(s) should be used when quantifying this burden.
    UNASSIGNED: We conducted a scoping review aimed at identifying which methods have been used to conduct such work and quantified their performance. We were also interested in examining how sex and gender considerations were considered within selected studies.
    UNASSIGNED: Using a standardized approach, we identified studies published between 2012 and 2022 that aimed to document the financial burden of caregivers to child and adolescent patients. Our search strategy was applied to the MEDLINE, Embase, CINHAL, and Academic Search Premier databases.
    UNASSIGNED: Manuscript selection was performed by pairs of reviewers.
    UNASSIGNED: Data extraction was performed by one reviewer with a second reviewer performing quality control. Results were reported using a narrative approach.
    UNASSIGNED: We identified 9801 unique citations, of which 200 were included in our review. Selected studies covered various disease area (eg, infection/parasitic diseases [n = 31, 16%]) and included quantitative (n = 180, 90%), qualitative (n = 4, 2%) and mixed study designs (n = 16, 8%). Most studies (n = 182, 91%) used questionnaires/surveys, either alone or in combination with other methods, to assess caregivers\' financial burden. Less than half (n = 93, 47%) of studies reported on caregivers\' sex and none reported on their gender.
    UNASSIGNED: We conducted an unrestricted review of published studies examining caregiver\'s financial burden which allowed us to identify general methodological trends observed in this literature. We believe this work may help improve future studies focusing on this important issue.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Review
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Systematic Review
    这项系统评价检查了癌症护理成本,病人的经济负担,以及他们在中国大陆的经济应对策略。我们纳入了38项定量研究,这些研究报告了中英文癌症护理和患者应对策略的自付费用(PROSPERO:CRD42021273989)。我们搜索了PubMed,Embase,奥维德,WebofScience,科克伦,CNKI,万方数据从2009年1月1日至2022年8月10日。我们参考了报告观察性研究的标准,以评估纳入研究的方法学质量和透明报告,并以叙述方式报告了成本。年平均医疗费用(包括住院和门诊费用以及自购药物的费用)从每名患者7421美元到10,297美元不等。一项研究调查了5年的医疗费用,显示住院费用占医疗总费用的51.6%,其次是自购药物(43.9%)。年度医疗费用占家庭年收入的百分比从36.0%到63.1%不等,占比为51.0%。常见的应对策略包括借钱和减少家庭开支以及从基本保健服务中支出。住院护理费用和自购药品是癌症护理医疗费用的主要驱动因素,许多受影响的家庭肩负着非常沉重的经济负担。
    This systematic review examined cancer care costs, the financial burden for patients, and their economic coping strategies in mainland China. We included 38 quantitative studies that reported out-of-pocket payment for cancer care and patients\' coping strategies in English or Chinese (PROSPERO: CRD42021273989). We searched PubMed, Embase, Ovid, Web of Science, Cochrane, CNKI, and Wanfang Data from 1 January 2009 to 10 August 2022. We referred to the standards for reporting observational studies to assess the methodological quality and transparent reporting of the included studies and reported the costs narratively. Annual mean medical costs (including inpatient and outpatient costs and fees for self-purchasing drugs) ranged from USD 7421 to USD 10,297 per patient. One study investigated medical costs for 5 years and indicated that inpatient costs accounted for 51.6% of the total medical costs, followed by self-purchasing drugs (43.9%). Annual medical costs as a percentage of annual household income ranged from 36.0% to 63.1% with a metaproportion of 51.0%. The common coping strategies included borrowing money and reduction of household expenses and expenses from basic health services. Costs of inpatient care and self-purchasing drugs are major drivers of medical costs for cancer care, and many affected households shoulder a very heavy financial burden.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    癌症存活期间的金融毒性主要在美国进行研究;47-49%的癌症幸存者报告了经济困难,12-63%报告了由于治疗费用而导致的债务。金融毒性受每个国家的经济状况和医疗体系的影响。我们旨在回顾日本金融毒性的证据。使用PubMed和Ichushi数据库进行了系统搜索。我们纳入了英语或日语同行评审的文章,这些文章(1)探讨了由于癌症诊断和治疗而面临财务毒性的癌症患者的经验,(2)特定于日本,(3)重点关注癌症患者的财务毒性经历。数据提取集中在患者的经历上,家庭,和医疗保健提供者。主要主题是根据先前的研究综合而成的。搜索产生了来自PubMed的632条引文和来自Ichushi的21条引文,并确定了非重复。其中,共选取31篇文章进行全文综述。文献分为描述以下要素的研究:(A)金融毒性的风险因素,(b)财务毒性的描述,(c)心理反应,(d)金融毒性的应对策略,(e)对治疗结果的影响。只有三项研究报告了综合的财务毒性评分。此外,治疗成本影响医生的治疗决策,患者及其家人采取了各种策略来应对治疗费用。两项研究表明,当前收入低和年龄小是高风险因素。至于支持系统的利用,大约70%的患者使用了高成本的医疗费用系统,20%的人使用了疾病福利制度,40%使用医疗费用扣除制度。日本的许多癌症患者在癌症存活期间遭受经济毒性。其中一个原因是支持金融毒性的系统意识不足,实际利用率低。有必要积极鼓励患者向医疗保健提供者提问,改善患者与支持系统之间的联系,重建支持系统设计,完善制度宣传方法。
    Financial toxicity during cancer survival has been studied mainly in the United States; 47-49% of cancer survivors reported financial hardships and 12-63% reported debt owing to treatment costs. Financial toxicity is influenced by each country\'s economic status and healthcare system. We aimed to review the evidence on financial toxicity in Japan. A systematic search was performed using PubMed and Ichushi databases. We included English or Japanese peer-reviewed articles that (1) explored the experiences of cancer patients facing financial toxicity due to cancer diagnosis and treatment, (2) were specific to Japan, and (3) focused on the experiences of financial toxicities among cancer patients. Data were extracted focusing on the experiences of patients, families, and healthcare providers. The main themes were synthesized based on a previous study. The search yielded 632 citations from PubMed and 21 from Ichushi, and non-duplicates were identified. Of these, 31 articles were selected for full-text review. Literature was divided into studies describing the following elements: (a) risk factors for financial toxicity, (b) description of financial toxicity, (c) psychological reactions, (d) coping strategies for financial toxicity, and (e) impact on treatment outcomes. Only three studies reported comprehensive financial toxicity scores. Furthermore, treatment costs influenced physicians\' treatment decisions, and patients and their families adopted various strategies to cope with treatment costs. Two studies showed that low current income and younger age were high-risk factors. As for utilization of the support system, approximately 70% of the patients used the high-cost medical expense system, 20% used the sickness benefit system, and 40% used the medical expense deduction system. Many cancer patients in Japan suffer from financial toxicity during cancer survival. One reason for this is that the awareness of the system supporting financial toxicity is insufficient and actual utilization is low. It is necessary to actively encourage patients to ask healthcare providers questions, improve the link between patients and the support system, reconstruct the support system design, and improve the method of publicizing the system.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    心力衰竭(HF)的最佳医疗管理提高了生活质量,降低死亡率,减少住院。成本可能导致对HF药物的依从性欠佳,尤其是血管紧张素受体-脑啡肽酶抑制剂和钠-葡萄糖协同转运蛋白-2抑制剂。患者经历HF药物治疗费用包括经济负担,财务压力,和金融毒性。尽管有研究研究某些慢性病患者的财务毒性,没有有效的工具来测量HF的金融毒性,关于HF和经济毒性患者的主观体验的数据很少。减少HF相关金融毒性的策略包括进行系统性改变以最小化成本分担,优化共享决策,实施降低药品成本的政策,扩大保险范围,并使用金融导航服务和折扣计划。临床医生还可以通过常规临床护理中的各种策略来改善患者的财务健康。需要未来的研究来研究金融毒性和相关的HF患者经历。
    Optimal medical management of heart failure (HF) improves quality of life, decreases mortality, and decreases hospitalizations. Cost may contribute to suboptimal adherence to HF medications, especially angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter-2 inhibitors. Patients\' experiences with HF medication cost include financial burden, financial strain, and financial toxicity. Although there has been research studying financial toxicity in patients with some chronic diseases, there are no validated tools for measuring financial toxicity of HF, and very few data on the subjective experiences of patients with HF and financial toxicity. Strategies to decrease HF-associated financial toxicity include making systemic changes to minimize cost sharing, optimizing shared decision-making, implementing policies to lower drug costs, broadening insurance coverage, and using financial navigation services and discount programs. Clinicians may also improve patient financial wellness through various strategies in routine clinical care. Future research is needed to study financial toxicity and associated patient experiences for HF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    未经评估:癌症治疗通常会给患者带来经济负担,包括医疗费用以及治疗引起的残疾,从而导致“财务毒性”(FT)和生活质量下降。这篇综述的目的是描述与头颈部癌症(HNC)治疗相关的FT,包括直接和间接成本的量化以及测量工具的描述。
    未经授权:PubMed,Embase,科克伦图书馆,和WebofScience数据库进行搜索,以识别2022年4月之前发表的文章。如果评估HNC治疗的直接或间接成本,则包括全文发表的研究;如果不关注HNC或财务负担,则排除研究。评估了偏见的风险,并综合了研究结果。
    UNASSIGNED:数据库搜索产生了530个独特的研究,33项研究符合纳入标准.在几项研究中,HNC患者的医疗费用高于其他癌症或对照患者。主要外科手术,颈淋巴结清扫术,游离皮瓣重建,重症监护病房的入院增加了医院费用。手术加放化疗是最昂贵的治疗方法,放化疗增加了并发症相关的医疗费用.在一些研究中,>50%的接受HNC治疗的患者残疾并且没有恢复工作。HNC治疗的间接成本的最大贡献者之一是终身工资的损失。HNC患者有抑郁症的风险,焦虑,和社会孤立,这与生活质量下降和治疗不依从性有关。用于评估HNC患者FT的唯一工具是财务毒性综合评分(COST)和毒性财务指数(FIT)。
    未经批准:金融毒性在HNC患者中非常普遍。需要进一步的研究来验证用于量化HNC患者FT的评估工具。
    UNASSIGNED: Cancer treatment often results in financial burdens for patients including healthcare costs as well as treatment-induced disability leading to \"financial toxicity\" (FT) and decreased quality of life. The purpose of this review is to describe FT related to head and neck cancer (HNC) treatment, including quantifications of direct and indirect costs and descriptions of measurement tools.
    UNASSIGNED: PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify articles published before April 2022. Full-text published studies were included if they assessed direct or indirect costs of HNC treatment; studies were excluded if they did not focus on HNC or financial burden. The risk of bias was assessed, and the results of the studies were synthesized.
    UNASSIGNED: Database searches yielded 530 unique studies, and 33 studies met the criteria for inclusion. Medical expenses for patients with HNC were higher than for patients with other cancers or controls in several studies. Major surgical procedures, neck dissection, free-flap reconstruction, and intensive care unit admission increased hospital costs. Trimodal therapy with surgery plus chemoradiation represented the most expensive treatment, and chemoradiation increased complication-related health care costs. In several studies, >50% of patients treated for HNC were disabled and did not return to work. One of the greatest contributors to the indirect cost of HNC treatment is the loss of lifetime wages. Patients with HNC are at risk for depression, anxiety, and social isolation, which are linked to a decreased quality of life and treatment non-adherence. The only tools used to assess FT in patients with HNC are the Comprehensive Score for financial Toxicity (COST) and the Financial Index of Toxicity (FIT).
    UNASSIGNED: Financial toxicity is highly prevalent among patients with HNC. Further research is needed to validate the assessment tools for quantifying FT in HNC patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:经济负担是一种普遍现象,经常在唐氏综合症儿童的照顾者中注意到。它呼应对照顾者的身心健康的不利影响。经济负担包括直接医疗费用,直接非医疗保健费用,和间接成本,对唐氏综合症患者的家庭来说是巨大的,以及社会。证据,在这个地区,是必要的,以减少精神压力和促进经济福祉的照顾者。
    方法:在这篇综述中,评估唐氏综合征儿童照顾者经济负担的定量研究将被考虑.我们将在2000年至2022年期间对电子数据库CINAHL进行系统的文献检索,EBSCO,EMBASE,PubMed,Scopus,WebofScience,还有EconLit.将进行额外的灰色文献检索。两名研究人员将独立进行筛查和数据提取,并评估偏倚风险。
    结论:这篇综述试图从社会角度和个体角度系统地分析唐氏综合征儿童照顾者的经济负担。目前的研究将为研究人员提供证据基础,院士,和社会在确定护理人员基于需求的学习方面,以及为患有唐氏综合症的儿童选择合适的治疗方法。
    背景:PROSPEROCRD42021265312。
    Financial burden is a common phenomenon, often noticed in the caregivers of children with Down syndrome. It echoes adverse effects on the caregiver\'s mental and physical health. The economic burden covers direct healthcare costs, direct non-health-care costs, and indirect costs and is substantial for the family of a person with Down syndrome, as well as for society. Evidence, in this area, is necessary to reduce mental stress and promote financial well-being among caregivers.
    In this review, quantitative studies that assess the economic burden on caregivers of children with Down syndrome will be considered. We will perform a systematic literature search conducted from the year 2000 to 2022 on electronic databases CINAHL, EBSCO, EMBASE, PubMed, Scopus, Web of Science, and EconLit. An additional gray literature search will be carried out. Two researchers will independently conduct the screening and data extraction and assess the risk of bias.
    The review attempts to methodically analyze the economic burden among caregivers of children with Down syndrome from the societal perspective and individual perspectives. The current study will provide an evidence base to researchers, academicians, and society in identifying need-based learning to caregivers, and the selection of appropriate therapies for children suffering from Down syndrome.
    PROSPERO CRD42021265312.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    地中海贫血是一组先天性血红蛋白(Hb)疾病,其特征是血红蛋白四聚体的一个或多个珠蛋白链的产生减少或完全减少。随后无节制地破坏红细胞(RBC),导致严重的贫血。疾病的严重程度通常仍然变化很大。患有地中海贫血的儿童患有该疾病的后果和治疗并发症。这种疾病还会对家庭成员造成负面影响,精神上受苦的人,社会,财政上,甚至身体上。在这次审查中,我们强调家庭和照顾者所经历的挑战;例如,反复输血是组织伤亡的主要原因,发病率,和致命的临床结果。直到骨髓移植和基因治疗开始,地中海贫血的治疗方法才成功。
    Thalassemias are a group of congenital hemoglobin (Hb) disorders distinguished by dwindling or total curtailment of production of one or more globin chains of hemoglobin tetramers, ensuing in unrestrained destruction of red blood cells (RBC) that causes severe anemia. The severity of the disease often remains immensely variable. Children with thalassemia suffer from the disease\'s consequences and treatment complications. The disease also causes a negative impact on family members, who suffer mentally, socially, financially, and even physically. In this review, we highlight the challenges experienced by the family and caregivers; for instance, repeated blood transfusion as the dominant origin of tissue casualty, morbidity, and fatal clinical outcomes. Treatment modalities regarding thalassemias were not successful until the inception of bone marrow transplantation and gene therapy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号