Evidence map›Paper›PMID 25378730›Full record

ArticleBulletin of the World Health Organization2014

Catastrophic household expenditure on health in Nepal: a cross-sectional survey.

Eiko Saito, Stuart Gilmour, Md Mizanur Rahman, Ghan Shyam Gautam, Pradeep Krishna Shrestha, Kenji Shibuya

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bulletin of the World Health Organization, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 2 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 2 syntheses or guidelines pooled it, 146 citations in OpenAlex.

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  19. Payment mechanism for institutional births in Nepal.Archives of public health = Archives belges de sante publique · 2021
    Article
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Eiko SaitoGraduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan .
Stuart GilmourGraduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan .
Md Mizanur RahmanGraduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan .
Ghan Shyam GautamDeutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Kathmandu, Nepal .
Pradeep Krishna ShresthaInstitute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal .
Kenji ShibuyaGraduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan .
The University of Tokyo · JPTribhuvan University Teaching Hospital · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the incidence of - and illnesses commonly associated with - catastrophic household expenditure on health in Nepal.

methodsWe did a cross-sectional population-based survey in five municipalities of Kathmandu Valley between November 2011 and January 2012. For each household surveyed, out-of-pocket spending on health in the previous 30 days that exceeded 10% of the household's total expenditure over the same period was considered to be catastrophic. We estimated the incidence and intensity of catastrophic health expenditure. We identified the illnesses most commonly associated with such expenditure using a Poisson regression model and assessed the distribution of expenditure by economic quintile of households using the concentration index.

findingsOverall, 284 of the 1997 households studied in Kathmandu, i.e. 13.8% after adjustment by sampling weight, reported catastrophic health expenditure in the 30 days before the survey. After adjusting for confounders, this expenditure was found to be associated with injuries, particularly those resulting from road traffic accidents. Catastrophic expenditure by households in the poorest quintile were associated with at least one episode of diabetes, asthma or heart disease.

conclusionIn an urban area of Nepal, catastrophic household expenditure on health was mostly associated with injuries and noncommunicable diseases such as diabetes and asthma. Throughout Nepal, interventions for the control and management of noncommunicable diseases and the prevention of road traffic accidents should be promoted. A phased introduction of health insurance should also reduce the incidence of catastrophic household expenditure.

Indexed as

Family CharacteristicsCatastrophic IllnessCross-Sectional StudiesFemaleFinancing, PersonalHealth ExpendituresHumansMaleNepalRisk Factors

Identifiers

PMID25378730
PMCPMC4208475
OpenAlexW2165425080

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.