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Economics of health informatics in developing countries

Hébert RJ

Stud Health Technol Inform, 2011;164:162-7.
PMID: 21335705

Health Informatics (HI) has become a world wide issue since 2005 when the WHO Health Metrics Network (HMN) was formed to encourage all of the developing countries (151) to get started in eHealth. Prior to this HMN initiative the only countries with HI in place were the developed countries (40) and a few developing countries (Jamaica, Malaysia, etc.) that were just getting started in HI with a very limited number of applications compared to the developed countries. This paper suggests that much of the experience in HI gained in the developed countries can be shared with the developing countries as 'lessons learnt' - as long as the issue of economics is kept front and foremost in the planning.

Matched MeSH terms: Economics, Medical*
Fulltext What to expect in 2024: important health economics and outcomes research (HEOR) trends

Abraham I, Hiligsmann M, Lee KKC, Citrome L, Colombo GL, Gregg M

J Med Econ, 2024;27(1):69-76.
PMID: 38122829 DOI: 10.1080/13696998.2023.2291604
Matched MeSH terms: Economics, Medical*
Economic evaluation of respiratory medication therapy adherence clinic (RMTAC) on asthma patients in Malaysia. [Abstract]

Yong YV, Shafie AA

Value Health, 2015 Nov;18(7):A501.
PMID: 26532812 DOI: 10.1016/j.jval.2015.09.1419

Objectives: To evaluate the long-term cost-effectiveness of RMTAC (an adjunct
pharmaceutical asthma management) vs. usual physician care clinic by using decision analytic modelling method. Methods: A dynamic adherence asthma Markov
cohort model was developed. The economic evaluation was based on a lifetime
horizon and cycle length of one month, from the healthcare provider‘s (Ministry
of Health) perspective, with the outcomes assessed in cost per QALY gained and
cost per hospitalization averted. Probabilities of asthma control-adherence states
from RMTAC database, costs from national sources, utilities using standard gamble method on Malaysia’s asthma patients, and other inputs from secondary data
sources were used to inform the probabilistic model, according to gender and age
subgroups. A scenario analysis was conducted to test the structural assumption on
follow-up visits after the final treatment visit. Results: In female subgroup, RMTAC
management dominates the usual care by having 0.91 (95% CI 0.24 – 1.69) QALY
gained and 0.58 (95% CI -2.30 – 6.23) hospitalization averted, at a lower cost. For male
subgroup, the ICERs were RM10 (95% CI -RM14431 – RM8323) per QALY gained and
RM18 (95% CI -RM35790 – RM30266) per hospitalization averted. At the willingnessto-pay threshold of RM29000 per an additional QALY gained, the RMTAC intervention
is likely to be cost-effective 99% and 57% of the time (for QALY and hospitalization
outcome, respectively). The analysis was robust to assumptions of follow-up visits
frequency and patients’ gender. Conclusions: Implementing RMTAC in Malaysia
has high probability of being more cost-effective than the usual care management
for both male and female subgroups across all age groups. Further investigation is
necessary to ensure that implementing this decision does not exceed the overall
national healthcare expenditure

Study site : Universiti Sains Malaysia, Penang, Malaysia

Matched MeSH terms: Economics, Medical
The relative efficiency of schizophrenia health care systems: an international comparison using data envelopment analysis

Weatherall J, Simonsen J, Odlaug BL

J Med Econ, 2020 Oct;23(10):1186-1192.
PMID: 32573296 DOI: 10.1080/13696998.2020.1786393

AIM: To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.
METHODS: The DEA was performed using countries as decision-making units, schizophrenia disease investment (cost of disease as a percentage of total health care expenditure) as the input, and disability-adjusted life years (DALYs) per patient due to schizophrenia as the output. Data were obtained from the Global Burden of Disease 2017 study, the World Bank Group, and a literature search of the PubMed database.
RESULTS: Data were obtained for 44 countries; of these, 34 had complete data and were included in the DEA. Disease investment (percentage of total health care expenditure) ranged from 1.11 in Switzerland to 6.73 in Thailand. DALYs per patient ranged from 0.621 in Lithuania to 0.651 in Malaysia. According to the DEA, countries with the most efficient schizophrenia health care were Lithuania, Norway, Switzerland and the US (all with efficiency score 1.000). The least efficient countries were Malaysia (0.955), China (0.959) and Thailand (0.965).
LIMITATIONS: DEA findings depend on the countries and variables that are included in the dataset.
CONCLUSIONS: In this international DEA, despite the difference in schizophrenia disease investment across countries, there was little difference in output as measured by DALYs per patient. Potentially, Lithuania, Norway, Switzerland and the US should be considered 'benchmark' countries by policy makers, thereby providing useful information to countries with less efficient systems.

Matched MeSH terms: Economics, Medical*
Editorial: To serve all the people

Chen PC

Med J Malaysia, 1975 Jun;29(4):237-9.
PMID: 1196171
Matched MeSH terms: Economics, Medical
Family-centred hospital treatment in the aboriginal people of West Malaysia

Bolton JM

Community Health (Bristol), 1973 Sep-Oct;5(2):70-4.
PMID: 4787593
Matched MeSH terms: Economics, Medical
Cost per anaesthetic

Liew RP

Med J Malaysia, 1973 Mar;27(3):182-7.
PMID: 4268920
Matched MeSH terms: Economics, Medical
Utilization of debate as an educational tool to learn health economics for dental students in Malaysia

Khan SA, Omar H, Babar MG, Toh CG

J Dent Educ, 2012 Dec;76(12):1675-83.
PMID: 23225687

Health economics, a special branch of science applying economic principles to the health delivery system, is a relatively young subdiscipline. The literature is scanty about teaching health economics in the medical and dental fields. Delivery methods of this topic vary from one university to another, with lectures, seminars, and independent learning reported as teaching/learning tools used for the topic. Ideally, debates should foster the development of logical reasoning and communication skills. Health economics in dentistry is taught under the community oral health module that constitutes part of an outcome-based dental curriculum in a private dental school in Kuala Lumpur, Malaysia. For this study, the students were divided into two groups: active participants (active debaters) and supporting participants (nonactive debaters). The debate style chosen for this activity was parliamentary style. Active and nonactive debaters' perceptions were evaluated before and after the activity through a structured questionnaire using a five-point rating scale addressing the topic and perceptions about debate as an educational tool. Cronbach's alpha coefficient was used as a measure of internal consistency for the questionnaire items. Among a total of eighty-two third-year dental students of two successive cohorts (thirty-eight students and forty-four students), seventy-three completed the questionnaire, yielding a response rate of 89 percent. Students' responses to the questionnaire were analyzed with the Kruskal-Wallis analysis of variance test. Results revealed that the students felt that their interest in debate, knowledge of the topic, and reinforcement of the previous knowledge had improved following participation in the debate. Within the limitations of this study, it can be concluded that debate was a useful tool in teaching health economics to dental students.

Matched MeSH terms: Economics, Medical*
Fulltext Economic burden of diabetic care in government health facilities in Selangor

Sharifa Ezat, W.P., Azimatun, N.A., Amrizal, M.N., Rohaizan, J., Saperi, B.S.

Malaysian Journal of Community Health, 2009;15(2):17-26.
MyJurnal

Background : The worldwide prevalence of diabetes is increasing, as is the demand for and cost of medical care. Diabetic Mellitus (DM) prevalence in Malaysia rose from 6.3% of the population in 1986 to 8.3% in 1996 and costs need to be managed more effectively.
Objective : To estimate the financial burden of diabetic care, including providers’ and patients’ costs in government facilities in Selangor and to determine factors influencing cost of diabetic care.
Methodology : A cross-sectional study was conducted from September to November 2005 among Hospitals with and without Specialist and Health Clinics. Total sample of 361 subjects with type 2 diabetes representing both inpatient and outpatient were chosen randomly. Results were analyzed using SPSS version 13.0.
Results : The average cost for a diabetic patients’ admission in a Hospital with Specialist was RM1951 and RM1974 for patient admitted in a Hospital without Specialist and these cost difference was not statistically significant (p>0.05). Providers’ mean cost for outpatient care was RM772.69 and RM761.07 respectively for Hospital with Specialist and Hospital without Specialist per year. As for the health clinics the average providers’ cost for a patient was RM385.92 per year. The cost difference was statistically significant (p0.05). The mean total costs of outpatient care were RM841.46, RM832.80 and RM458.01 per year for Hospital with Specialist, Hospital without Specialist and Health Clinics respectively. Level of care and length of stay were the influencing factors for inpatient provider’s cost. The overall provider’s cost for outpatient diabetic care was influenced by level of care, number of visits and complications. Cost of treating diabetes mellitus year 2004, was estimated at RM18,956,021.51 which was equivalent to 3.3% of total state health expenditure.
Conclusion : As much as 60.2 % was spent on management of outpatient diabetic care and 39.8% for management of inpatient diabetic care. Financial burden of diabetic care is predominantly for outpatient care. Therefore, effective and efficient management of outpatient care is needed to improve allocate efficiency, equity, accessibility and appropriateness of the health care system so that the health care services delivered to the nation are of good quality.

Matched MeSH terms: Economics, Medical*
Value of Information in Asia: Concepts, Current Use, and Future Directions

Dilokthornsakul P, McQueen RB, Chaiyakunapruk N, Spackman E, Watanabe JH, Campbell JD

Value Health Reg Issues, 2016 May;9:99-104.
PMID: 27881269 DOI: 10.1016/j.vhri.2015.12.003

Health technology assessment is a form of health policy research that provides policymakers with information relevant to decisions about policy alternatives. Findings from cost-effectiveness analysis (CEA) are one of the important aspects of health technology assessment. Nevertheless, the more advanced method of value of information (VOI), which is recommended by the International Society for Pharmacoeconomics and Outcomes Research and Society for Medical Decision Making Modeling Good Research Practices Task Force, has rarely been applied in CEA studies in Asia. The lack of VOI in Asian CEA studies may be due to limited understanding of VOI methods and what VOI can and cannot help policy decision makers accomplish. This concept article offers audiences a practical primer in understanding the calculation, presentation, and policy implications of VOI. In addition, it provides a rapid survey of health technology assessment guidelines and literature related to VOI in Asia and discusses the future directions of VOI use in Asia and its potential barriers. This article will enable health economists, outcomes researchers, and policymakers in Asia to better understand the importance of VOI analysis and its implications, leading to the appropriate use of VOI in Asia.

Matched MeSH terms: Economics, Medical
Medicines prices and Malaysia--untangling the medicines web

Hill S

PLoS Med, 2007 Mar 27;4(3):e149.
PMID: 17388686
Matched MeSH terms: Economics, Medical
Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia

Babar ZU, Ibrahim MI, Singh H, Bukahri NI, Creese A

PLoS Med, 2007 Mar 27;4(3):e82.
PMID: 17388660

Malaysia's stable health care system is facing challenges with increasing medicine costs. To investigate these issues a survey was carried out to evaluate medicine prices, availability, affordability, and the structure of price components.

Matched MeSH terms: Economics, Medical
Increased burden of disease and role of health economics: Asia-pacific region

Shah S, Abbas G, Hanif M, Anees-Ur-Rehman, Zaman M, Riaz N, et al.

Expert Rev Pharmacoecon Outcomes Res, 2019 Oct;19(5):517-528.
PMID: 31401898 DOI: 10.1080/14737167.2019.1650643

Background: Health-care systems in Asian countries are diverse. The economic evaluation provides information on how to make efficient use of the resources available to obtain the maximum benefits. In Asia, diseases such as cardiovascular diseases (CVDs), diabetes mellitus (DM), tuberculosis (TB) and epilepsy generate a heavy economic burden. The objective of this article is to provide a review of the economic burden of health to patients in Asian countries. Areas covered: All data were collected from already published research article and review papers. The databases searched were Science Direct, PubMed, MEDLINE and Google scholar. We found a total of 4456 articles on health economics. After reviewing the title, only 876 relevant articles were considered. Only 92 (n = 92) articles were considered on the basis of inclusion and exclusion criteria. Expert opinion: Available data give evidence that diseases are linked to the low socio-economic status of the Asian population. The cost per capita is high in Asian countries due to insufficient health-care facilities. The cost per capita in Asian countries ranges from $23 (Pakistan) to $1775 (Taiwan). The per capita cost of Malaysia, China, Singapore, and Thailand is $27 $83, $75, and $27, respectively.

Matched MeSH terms: Economics, Medical