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  1. Article ; Online: A comprehensive examination of the economic impact of out-of-pocket health expenditures in India.

    Nanda, Mehak / Sharma, Rajesh

    Health policy and planning

    2023  Volume 38, Issue 8, Page(s) 926–938

    Abstract: More than 50% of health expenditure is financed through out-of-pocket payments in India, imposing a colossal financial burden on households. Amidst the rising incidence of non-communicable diseases, injuries, and an unfinished agenda of infectious ... ...

    Abstract More than 50% of health expenditure is financed through out-of-pocket payments in India, imposing a colossal financial burden on households. Amidst the rising incidence of non-communicable diseases, injuries, and an unfinished agenda of infectious diseases, this study examines comprehensively the economic impact of out-of-pocket health expenditure (OOPE) across 17 disease categories in India. Data from the latest round of the National Sample Survey (2017-18), titled 'Household Social Consumption: Health', were employed. Outcomes, namely, catastrophic health expenditure (CHE), poverty headcount ratio, distressed financing, foregone care, and loss of household earnings, were estimated. Results showed that 49% of households that sought hospitalization and/or outpatient care experienced CHE and 15% of households fell below the poverty line due to OOPE. Notably, outpatient care was more burdensome (CHE: 47.8% and impoverishment: 15.0%) than hospitalization (CHE: 43.1% and impoverishment: 10.7%). Nearly 16% of households used distressed sources to finance hospitalization-related OOPE. Cancer, genitourinary disorders, psychiatric and neurological disorders, obstetric conditions, and injuries imposed a substantial economic burden on households. OOPE and associated financial burden were higher among households where members sought care in private healthcare facilities compared with those treated in public facilities across most disease categories. The high burden of OOPE necessitates the need to increase health insurance uptake and consider outpatient services under the purview of health insurance. Concerted efforts to strengthen the public health sector, improved regulation of private healthcare providers, and prioritizing health promotion and disease prevention strategies are crucial to augment financial risk protection.
    MeSH term(s) Humans ; Health Expenditures ; Delivery of Health Care ; Poverty ; Income ; India ; Catastrophic Illness
    Language English
    Publishing date 2023-07-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 632896-9
    ISSN 1460-2237 ; 0268-1080
    ISSN (online) 1460-2237
    ISSN 0268-1080
    DOI 10.1093/heapol/czad050
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  2. Article ; Online: A Review of Patient Satisfaction and Experience with Telemedicine: A Virtual Solution During and Beyond COVID-19 Pandemic.

    Nanda, Mehak / Sharma, Rajesh

    Telemedicine journal and e-health : the official journal of the American Telemedicine Association

    2021  Volume 27, Issue 12, Page(s) 1325–1331

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) COVID-19 ; Humans ; Pandemics ; Patient Satisfaction ; Reproducibility of Results ; SARS-CoV-2 ; Telemedicine
    Language English
    Publishing date 2021-03-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2035659-6
    ISSN 1556-3669 ; 1530-5627
    ISSN (online) 1556-3669
    ISSN 1530-5627
    DOI 10.1089/tmj.2020.0570
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  3. Article ; Online: COVID-19: A Comprehensive Review of Epidemiology and Public Health System Response in Nordic Region.

    Nanda, Mehak / Sharma, Rajesh

    International journal of health services : planning, administration, evaluation

    2021  Volume 51, Issue 3, Page(s) 287–299

    Abstract: This paper investigates the epidemiology and public health response of novel coronavirus infection (COVID-19) in the Nordic region. The data on cases and deaths due to COVID-19 were drawn from the European Centre for Disease Prevention and Control. The ... ...

    Abstract This paper investigates the epidemiology and public health response of novel coronavirus infection (COVID-19) in the Nordic region. The data on cases and deaths due to COVID-19 were drawn from the European Centre for Disease Prevention and Control. The data on age- and sex-wise cases, deaths and intensive care unit (ICU) admissions, and public health interventions in the Nordic region through November 10, 2020, were obtained from respective countries' health ministries. Sweden accounted for 60.59% of cases (162 240 of 267 768 cases) and 81% of deaths (6057 of 7477 cases) in the Nordic region. The incidence rate for the Nordic region was 989.59 per 100 000, varying from 327.30 per 100 000 in Finland to 1616.51 per 100 000 in Sweden, and the mortality rate for the region was 27.63 per 100 000, ranging from 5.3 per 100 000 in Norway to 60.35 per 100 000 in Sweden. The case-fatality ratio of the Nordic region was 2.79%. Females were more susceptible to COVID-19 infection than males (52.30% vs 47.66%), while males had a greater proportion of deaths (54.7%) and ICU need (71.99%) than females. It is imperative to continue with social distancing, mandatory masks, testing, prohibition of mass gatherings, isolation of confirmed cases, and preventing the importation of cases from other countries to avoid the further resurgence of cases.
    MeSH term(s) Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/prevention & control ; Child ; Child, Preschool ; Communicable Disease Control/organization & administration ; Female ; Humans ; Incidence ; Infant ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Public Health Administration ; SARS-CoV-2 ; Scandinavian and Nordic Countries/epidemiology ; Sex Distribution ; Young Adult
    Language English
    Publishing date 2021-03-03
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 184936-0
    ISSN 1541-4469 ; 0020-7314
    ISSN (online) 1541-4469
    ISSN 0020-7314
    DOI 10.1177/0020731421994840
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  4. Article: Review of COVID-19 epidemiology and public health response in Europe in 2020.

    Nanda, Mehak / Aashima / Sharma, Rajesh

    Clinical epidemiology and global health

    2021  Volume 12, Page(s) 100882

    Abstract: Objective: This study focuses on the epidemiology of COVID-19 in Europe and investigates public health response in severely hit countries.: Methods: European Centre for Disease Prevention and Control, Oxford COVID-19 Government Response Tracker and ... ...

    Abstract Objective: This study focuses on the epidemiology of COVID-19 in Europe and investigates public health response in severely hit countries.
    Methods: European Centre for Disease Prevention and Control, Oxford COVID-19 Government Response Tracker and Health System Response Monitor were referred. The relationship between stringency index and COVID-19 cases, and between speed of stringency implementation and growth of cases was examined using linear regression.
    Results: The case-fatality ratio (CFR) of Europe (2.35%) was higher than the global CFR (2.2%). United Kingdom, Russia, France, Italy, Spain, and Germany together, accounted for 61.15% of cases and 65.62% of deaths in Europe. Significant relationship was observed between growth of COVID-19 cases and late substantive stringency imposed by countries. Population aged 65 and above (r = 0.9037, p < 0.01) and male population (r = 0.8701, p < 0.01) were significantly and positively correlated with COVID-19 deaths. The public health system of even big European countries encountered roadblocks, such as shortages of healthcare resources and deferral of non-COVID-19 treatments while dealing with the unprecedented pandemic.
    Conclusion: Even big and richest European countries delayed the implementation of non-pharmaceutical interventions which led to rapid virus transmission. The pandemic has posed a reminder to make the public health system more resilient, as epidemics and pandemics of this nature will continue to threaten in future as well.
    Language English
    Publishing date 2021-10-30
    Publishing country India
    Document type Journal Article
    ISSN 2452-0918
    ISSN 2452-0918
    DOI 10.1016/j.cegh.2021.100882
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  5. Article ; Online: Review of COVID-19 epidemiology and public health response in Europe in 2020

    Mehak Nanda / Aashima / Rajesh Sharma

    Clinical Epidemiology and Global Health, Vol 12, Iss , Pp 100882- (2021)

    2021  

    Abstract: Objective: This study focuses on the epidemiology of COVID-19 in Europe and investigates public health response in severely hit countries. Methods: European Centre for Disease Prevention and Control, Oxford COVID-19 Government Response Tracker and Health ...

    Abstract Objective: This study focuses on the epidemiology of COVID-19 in Europe and investigates public health response in severely hit countries. Methods: European Centre for Disease Prevention and Control, Oxford COVID-19 Government Response Tracker and Health System Response Monitor were referred. The relationship between stringency index and COVID-19 cases, and between speed of stringency implementation and growth of cases was examined using linear regression. Results: The case-fatality ratio (CFR) of Europe (2.35%) was higher than the global CFR (2.2%). United Kingdom, Russia, France, Italy, Spain, and Germany together, accounted for 61.15% of cases and 65.62% of deaths in Europe. Significant relationship was observed between growth of COVID-19 cases and late substantive stringency imposed by countries. Population aged 65 and above (r = 0.9037, p < 0.01) and male population (r = 0.8701, p < 0.01) were significantly and positively correlated with COVID-19 deaths. The public health system of even big European countries encountered roadblocks, such as shortages of healthcare resources and deferral of non-COVID-19 treatments while dealing with the unprecedented pandemic. Conclusion: Even big and richest European countries delayed the implementation of non-pharmaceutical interventions which led to rapid virus transmission. The pandemic has posed a reminder to make the public health system more resilient, as epidemics and pandemics of this nature will continue to threaten in future as well.
    Keywords COVID-19 ; Europe ; Epidemiology ; Stringency ; Public health response ; Public aspects of medicine ; RA1-1270
    Subject code 940
    Language English
    Publishing date 2021-10-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
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  6. Article ; Online: The burden of chronic kidney disease in Asia, 1990-2019: Examination of estimates from global burden of disease 2019 study.

    Aashima / Nanda, Mehak / Sharma, Rajesh / Jani, Chinmay

    Nephrology (Carlton, Vic.)

    2022  Volume 27, Issue 7, Page(s) 610–620

    Abstract: Background: Chronic kidney disease (CKD) is a global public health issue, with Asia accounting for one of the highest CKD prevalence worldwide. This study examines the burden of CKD in Asian continent in the last three decades.: Data and methods: The ...

    Abstract Background: Chronic kidney disease (CKD) is a global public health issue, with Asia accounting for one of the highest CKD prevalence worldwide. This study examines the burden of CKD in Asian continent in the last three decades.
    Data and methods: The estimates of age, sex and year wise burden of CKD for 49 countries in Asia for 1990 to 2019 were procured from the Global Burden of Disease 2019 study.
    Findings: In 2019, there were 9.8 million [9.0-10.6 million] new cases and 763 024 [696 050-823 829] deaths due to CKD in Asia. Between 1990 and 2019, CKD prevalence doubled from 202.4 million [186.5-219.1 million] to 431.2 [400.3-462.0 million]. Although age-standardized incidence rate (ASIR) of CKD increased from 170.6 [156.7-186.2] in 1990 to 206.3 [190.4-223.4] per 100 000 person-years in 2019, the age-standardized mortality rate (ASMR) witnessed a modest reduction from 18.4/100 000 [17.0-20.1] to 17.3/100 000 [15.7-18.7]. In 2019, the ASIR spanned from 141.9/100 000 [126.2-159.2] in Tajikistan to 561.4/100 000 [524.6-598.6] in Saudi Arabia, and ASMR varied from 8.9/100 000 [7.2-9.8] in Japan to Saudi Arabia (52.9 [42.8-63.1]). Between 1990 and 2019, absolute count of CKD incident cases, deaths, prevalent cases and disability-adjusted life years (DALYs) increased 100% or more in 48/49, 32/49, 43/49 and 23/49 countries, respectively.
    Interpretation: CKD is widespread in the Asian region, with an alarming burden in resource-constrained countries. Strategies such as promoting awareness, screening among high-risk individuals, provision of cost-effective therapies, and increased healthcare coverage could help deal with the CKD epidemic in Asia.
    MeSH term(s) Asia/epidemiology ; Global Burden of Disease ; Humans ; Incidence ; Quality-Adjusted Life Years ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology
    Language English
    Publishing date 2022-05-13
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1303661-0
    ISSN 1440-1797 ; 1320-5358
    ISSN (online) 1440-1797
    ISSN 1320-5358
    DOI 10.1111/nep.14051
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    Zs.A 4822: Show issues Location:
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  7. Article ; Online: Type-2 Diabetes Mellitus (T2DM): Spatial-temporal Patterns of Incidence, Mortality and Attributable Risk Factors from 1990 to 2019 among 21 World Regions.

    Nanda, Mehak / Sharma, Rajesh / Mubarik, Sumaira / Aashima, Aashima / Zhang, Kai

    Endocrine

    2022  Volume 77, Issue 3, Page(s) 444–454

    Abstract: Purpose: Type-2 diabetes Mellitus (T2DM) is one of the leading causes of death and disability worldwide. This study examines temporal patterns of the global, regional, and national burden of T2DM in the last three decades.: Data and methods: The ... ...

    Abstract Purpose: Type-2 diabetes Mellitus (T2DM) is one of the leading causes of death and disability worldwide. This study examines temporal patterns of the global, regional, and national burden of T2DM in the last three decades.
    Data and methods: The estimates of age, sex and location-wise incident cases, deaths, prevalent cases, and disability-adjusted-life-years (DALYs) and risk factors for 21 regions and 204 countries are retrieved from the Global Burden of Disease 2019 study from 1990 to 2019. Socio-demographic index (SDI) is used as the indicator of the development status of countries, and quadratic regression is employed to examine the relationship between country-level age-standardized rates and SDI.
    Results: Globally, incident cases of T2DM more than doubled from 8.4 million[95% uncertainty interval, 7.8-9.1 million] in 1990 to 21.7 million[20.0-23.5 million] in 2019, and deaths more than doubled from 606,407[573,069-637,508] to 1.5 million[1.4-1.6 million] between 1990 and 2019. Global T2DM prevalence increased from 148.4 million[135.5-162.6 million] in 1990 to 437.9 million[402.0-477.0 million] in 2019. In 2019, global age-standardized prevalence rate stood at 5282.8/100,000[4853.6-5752.1], varying from 2174.5/100,000[1924.3-2470.5] in Mongolia to 19876.8/100,000[18211.1-21795.3] in American Samoa. SDI exhibited inverted-U shaped relationship with country-level age-standardised rates. Globally, high body-mass-index (51.9%), ambient particulate matter pollution (13.6%), smoking (9.9%) and secondhand smoke (8.7%) were the major contributing risk factors towards T2DM DALYs in 2019.
    Conclusion: With ubiquitously rising prevalent cases globally, particularly in low and middle-income countries and regions, T2DM requires immediate attention and targeted policy response worldwide centered on lifestyle interventions (e.g., physical activity, smoking, diet, and obesity), air pollution control and cost-effective timely treatment.
    MeSH term(s) Diabetes Mellitus, Type 2/epidemiology ; Global Burden of Disease ; Global Health ; Humans ; Incidence ; Quality-Adjusted Life Years ; Risk Factors
    Language English
    Publishing date 2022-07-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1194484-5
    ISSN 1559-0100 ; 1355-008X ; 0969-711X
    ISSN (online) 1559-0100
    ISSN 1355-008X ; 0969-711X
    DOI 10.1007/s12020-022-03125-5
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    Zs.A 3884: Show issues Location:
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  8. Article ; Online: Mapping Cancer in Africa

    Rajesh Sharma / Aashima / Mehak Nanda / Claudio Fronterre / Paul Sewagudde / Anna E. Ssentongo / Kelsey Yenney / Nina D. Arhin / John Oh / Forster Amponsah-Manu / Paddy Ssentongo

    Frontiers in Public Health, Vol

    A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020

    2022  Volume 10

    Abstract: ObjectiveCancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and ... ...

    Abstract ObjectiveCancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries.MethodsThe estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles.ResultsIn Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 – 1.3 million] and 711,429 [611,604 – 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 ...
    Keywords cancer burden ; mapping ; spatial epidemiology ; incidence ; mortality ; Africa ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
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  9. Article ; Online: Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates From GLOBOCAN 2020.

    Sharma, Rajesh / Aashima / Nanda, Mehak / Fronterre, Claudio / Sewagudde, Paul / Ssentongo, Anna E / Yenney, Kelsey / Arhin, Nina D / Oh, John / Amponsah-Manu, Forster / Ssentongo, Paddy

    Frontiers in public health

    2022  Volume 10, Page(s) 839835

    Abstract: Objective: Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and ... ...

    Abstract Objective: Cancer incidence and mortality rates in Africa are increasing, yet their geographic distribution and determinants are incompletely characterized. The present study aims to establish the spatial epidemiology of cancer burden in Africa and delineate the association between cancer burden and the country-level socioeconomic status. The study also examines the forecasts of the cancer burden for 2040 and evaluates infrastructure availability across all African countries.
    Methods: The estimates of age, sex, and country-specific incidence and mortality of 34 neoplasms in 54 African countries, were procured from GLOBOCAN 2020. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates, and the socioeconomic development of each country was measured using its human development index (HDI). We regressed age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and MIR on HDI using linear regression model to determine the relationship between cancer burden and HDI. Maps were generated for each cancer group for each country in Africa. The data about the cancer infrastructure of African countries were extracted from the WHO Cancer Country Profiles.
    Results: In Africa, an estimated 1.1 million new cases [95% uncertainty intervals (UIs) 1.0 - 1.3 million] and 711,429 [611,604 - 827,547] deaths occurred due to neoplasms in 2020. The ASIR was estimated to be 132.1/100,000, varying from 78.4/100,000 (Niger) to 212.5/100,000 (La Réunion) in 2020. The ASMR was 88.8/100,000 in Africa, ranging from 56.6/100,000 in the Republic of the Congo to 139.4/100,000 in Zimbabwe. The MIR of all cancer combined was 0.64 in Africa, varying from 0.49 in Mauritius to 0.78 in The Gambia. HDI had a significant negative correlation with MIR of all cancer groups combined and main cancer groups (prostate, breast, cervical and colorectal). HDI explained 75% of the variation in overall 5-year cancer survival (MIR). By 2040, the burden of all neoplasms combined is forecasted to increase to 2.1 million new cases and 1.4 million deaths in Africa.
    Conclusion: High cancer mortality rates in Africa demand a holistic approach toward cancer control and management, including, but not limited to, boosting cancer awareness, adopting primary and secondary prevention, mitigating risk factors, improving cancer infrastructure and timely treatment.
    MeSH term(s) Africa/epidemiology ; Humans ; Incidence ; Male ; Neoplasms/epidemiology ; Risk Factors ; Survival Rate
    Language English
    Publishing date 2022-04-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2022.839835
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