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Household expenditure on leprosy outpatient services in the Indian health system: A comparative study.

TIWARI, Ajun
et al
January 2018

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The primary objective of this study is to estimate the expenditure in primary (outpatient) care incurred by leprosy patients in two different health system settings in India. The secondary objective is to compare the effect of the health systems on consumer behaviour and practices. 

The study followed a cross-sectional design, where a cohort from the Union Territory of DNH (an administrative division ruled directly by the federal government) was compared with a cohort from Umbergaon block of Valsad district, Gujarat, India. A block is the smallest administrative unit under a district. The cohorts were leprosy cases detected between April 2015 and March, 2016. A sample of 120 participants from each group was selected randomly. In the financial year of 2015–16, DNH reported 425 and Umbergaon reported 287 cases. 

A household survey was conducted between June and October, 2016 by means of a structured questionnaire collecting data on patient demographics, HH socioeconomic status, accessibility of health services, treatment seeking history and OPD expenditure. Respondents were asked to report on the last three OPD visits, either in a public or private facility, in the last 6 months. 

The costs were categorized as direct and indirect expenditure. The direct part included the expenditure on consultation, investigations and medicines & supplies. The indirect part constituted expenditure on transport, food, and days lost during illness of the patient and attendant

PLOS Neglected Tropical Diseases, January 4, 2018

https://doi.org/10.1371/journal.pntd.0006181

Extra costs of living with a disability: A review and agenda for research

MITRA, Sophie
PALMER, Michael
KIM, Hoolda
MONT, Daniel
GROCE, Nora
April 2017

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Background
There has been a growing interest in disability and poverty on the international research and policy stages. Poverty assessments for persons with disabilities may be affected by the experience of extra costs associated with a disability.

Objective
This article provides a systematized review of the global literature on the direct costs associated with living with a disability at the individual or household level.

Methods
We searched three databases for peer-reviewed journal articles that estimated extra costs associated with disability: Econlit, SocIndex and PubMed.

Results
We found 20 such studies conducted in 10 countries. These studies were predominantly from high-income countries. Although studies were heterogeneous (e.g., in terms of disability measures and cost methodologies), estimated costs were sizeable and some patterns were consistent across studies. Costs varied according to the severity of disability, life cycle and household composition. Highest costs were observed among persons with severe disabilities, and among persons with disabilities living alone or in small sized households.

Disability and Health Journal
Volume 10, Issue 4, October 2017, Pages 475-484
https://doi.org/10.1016/j.dhjo.2017.04.007

Brief - Financial access to rehabilitation services

Handicap International
October 2015

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Presentations from the seminar are reported on the themes of: a diagnostic tool, universal health coverage, financial access experiences, Madagascar’s experience and advocacy. Presentations included: The economic diagnostic tool for physical and functional rehabilitation and its deployment in Burkhina Faso, Colombia and Laos;  Equity funds and cash transfers, link with UHC; Universal Health Coverage, contributory and case management schemes usable in order to finance physical and functional rehabilitation; Vietnam: Orthopaedic devices and fair cost recovery system;  Burundi: Financial access to healthcare and performance-based financing; Burkhina Faso: Equity fund for rehabilitation projects; Mali, Rwanda, Togo: Evaluation of three rehabilitation equity funds; Nepal: Cost calculation of assistive devices; Madagascar Experience (Operating and financial access of orthopaedic devices and physical rehabilitation services of Pzaga Mahajanga University Hospital,  Social Welfare Policy and Universal health coverage in Madagascar, Mutual Health Insurances)

Community based rehabilitation for people with disabilities in low and middle income countries : a systematic review

IEMMI, Valentina
et al
September 2015

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This Campbell Collaboration systematic review assesses the effectiveness and cost-effectiveness of community-based rehabilitation (CBR) for people with physical and mental disabilities in low- and middle-income countries, and/or their family, their carers, and their community. This review identified 15 studies that assessed the impact of community-based rehabilitation on the lives of people with disabilities and their carers in low- and middle-income countries. The studies included in the review used different types of community-based rehabilitation interventions and targeted different types of physical (stroke, arthritis, chronic obstructive pulmonary disease) and mental disabilities (schizophrenia, dementia, intellectual impairment). The authors conclude that the evidence on the effectiveness of CBR for people with disabilities in low- and middle-income countries suggests that CBR may be effective in improving the clinical outcomes and enhancing functioning and quality of life of the person with disabilities and his/her carer and recommend future studies will need to adopt better study designs, will need to focus on broader clients group, and to include economic evaluations

Campbell Systematic Reviews 2015:15

The economic costs of exclusion and gains of inclusion of people with disabilities : evidence from low and middle income countries

BANKS, Lena Morgon
POLACK, Sarah
2015

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This report, formed of two parts, provides robust empirical basis to support the theorized disability-poverty link. The first section presents a systematic review of the literature on the relationship between disability and economic poverty. The second section explores the economic consequences of the exclusion and inclusion of people with disabilities in the areas of education, employment and health. The key pathways through which these economic costs may arise are discussed and studies that have attempted to quantify the financial impacts are reviewed

What are the impacts of approaches to increase the accessibility to education for people with a disability across developed and developing countries and what is known about the cost-effectiveness of different approaches?

BAKHSHI, Parul
KETT, Maria
OLIVER, Kathryn
June 2013

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This study presents a mapping of existing evidence that provides information about the impact of initiatives that provide education for children with disabilities, and also identifies any studies that provide an analysis about the cost-effectiveness of existing initiatives. It is useful for policymakers, researchers, practitioners, parents of children with disabilities and the children themselves

Community volunteers : an asset for detecting and following up children with disabilities

INTERNATIONAL CENTER FOR EVIDENCE ON DISABILITY (ICED)
December 2012

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This video presents a  recording of a seminar held at the London School of Hygiene and Tropical Medicine (LSHTM) in November 2012.  The seminar explores the findings and recommendations from a four year CBM-funded project in Bangladesh and Pakistan to identify children with disabilities and connect them with appropriate rehabilitative services

The economic benefits of increasing the employment for people with disability

DELOITTE ACCESS ECONOMICS
August 2011

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This report estimates the increase in economic output that could be achieved by increasing employment outcomes for people with disabilities…The economic modelling presented in this report suggests that closing the gap between labour market participation rates and unemployment rates for people with and without disabilities by one-third would result in a cumulative $43 billion increase in Australia’s GDP over the next decade in real dollar terms. The modelling also suggests that GDP will be around 0.85% higher over the longer term, which is equivalent to an increase in GDP in 2011 of $12 billion.

The policy and program mechanisms for achieving these outcomes are not explicitly addressed in this report, nor does it address the costs associated with achieving an increase in employment participation. Rather, the aim of this report is to present the potential benefits associated with increasing employment participation for people with disabilities and provide a reference point for future policy discussion

Tools and methods for evaluating the efficiency of development interventions

PALENBERG, Markus A
April 2011

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"This report investigates tools and methods for assessing aid efficiency. It explains concepts of efficiency and efficiency analysis and presents a catalogue of 15 methods that can be used to assess the efficiency of aid interventions. Each method is described and characterised. Several general observations and recommendations conclude the report"
BMZ Evaluation Working Papers

Global status report on noncommunicable diseases 2010

WORLD HEALTH ORGANIZATION (WHO)
2011

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"This report sets out the statistics, evidence and experiences needed to launch a more forceful response to the growing threat posed by noncommunicable diseases. While advice and recommendations are universally relevant, the report gives particular attention to conditions in low- and middle-income countries, which now bear nearly 80% of the burden from diseases like cardiovascular disease, diabetes, cancer and chronic respiratory diseases. The health consequences of the worldwide epidemic of obesity are also addressed"

The cost of disability : final report

TRAVAGLIA, Sarah
et al
2010

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"The Cost of Disability Report identifies the additional resources (support, equipment, transport and time) and the costs associated with these resources that disabled people aged 18-64 years require to live in the community and to achieve an ordinary standard of living"
The report and budgets are available to download in pdf, word and excel formats

World alzheimer report 2010 : the global economic impact of dementia

WIMO, Anders
PRINCE, Martin
2010

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This report provides a global picture of the economic impact of Alzheimer's disease and dementia. "The report includes an estimate of the worldwide cost of dementia, including direct medical costs, direct non-medical costs and costs of informal (family) care. The estimates are broken down by world region and include analysis of the differences between low and high income countries. The report also contains important policy recommendations and makes clear to key decision-makers that doing nothing is not an option"

IDF diabetes atlas

UNWIN, Nigel
et al
2010

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This report presents evidence that diabetes is a global epidemic. It contains comprehensive information in the following sections: What is diabetes?; The Global Burden; Regional Overviews; Diabetes and Development; Linking Local to Global; Resources and Solutions; References; Additional Resources. This report is useful for health professionals, scientists, economists, policy-makers, and national and international agencies

Access to independent advocacy : an evidence review

TOWNSLEY, Ruth
MARRIOT, Anna
WARD, Linda
October 2009

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This report presents the findings of an evidence review investigating the costs, benefits and effectiveness of advocacy support for disabled people in the UK. The review examines the following four situations where disabled people are particularly at risk of losing choice and control over their lives: during transition to adulthood; when the children of disabled parents are subject to safeguarding procedures; when entry to residential care is a possibility; and when disabled people are victims or alleged perpetrators of anti-social behaviour. The executive summary, report and an easy to read version are available in downloadable pdf format. A framework for research on costs and benefits of independent advocacy is also provided. Audio and braille versions of the executive summary, the full report and the framework for research are available on request

Future sight loss UK (1) : the economic impact of partial sight and blindness in the UK adult population

ACCESS ECONOMIC PTY LIMITED
July 2009

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This report estimates the economic impact of partial sight and blindness in the UK adult population, including the direct and indirect costs of partial sight and blindness, and the burden of partial sight and blindness on health. In addition, the report completes an international comparison (Australia, US, Japan, and Canada) and several cost effectiveness analyses on strategic interventions that are expected to prevent and ameliorate the impact of sight loss in the UK adult population. Useful figures and tables are provided to present the results

Future sight loss UK (2) : an epidemiological and economic model for sight loss in the decade 2010 to 2020

MINASSIAN, Darwin
REIDY, Angela
2009

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This report provides estimates of the numbers of persons that were likely to have age-related macular disease, cataract, diabetic retinopathy and glaucoma at two points in time 2010 and 2020. Estimates of the baseline and cumulative costs to society of the prevailing health and social care provision and support in that time frame are provided using a cost of illness approach from the societal perspective. Useful figures and tables are provided to present the results

Cost-effectiveness of interventions to prevent disability in leprosy : a systematic review

VAN VEEN, N. H
et al
2009

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"Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions"
PLoS One, Vol 4, Issue 2

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