Laos Out-Of-Pocket Costs: an Observational Study on the Impact of Severe Childhood Illness on the Health, Wealth and Wellbeing of Household Members in Laos
NCT ID: NCT05239104
Last Updated: 2024-05-02
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
400 participants
OBSERVATIONAL
2022-11-01
2024-01-10
Brief Summary
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Detailed Description
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Participants will be recruited in outpatients, the emergency department (ED) or during hospital admission. Information on the participant's illness will be collected through health records where available. Household demographic data, financial costs and coping strategies associated with illness and health/wellbeing outcomes will be collected through parent/caregiver structured questionnaires. These will be conducted during presentation to outpatients/ED or during admission on the wards, with follow-up at 2 weeks and at 2 months post-presentation or post-discharge.
Average total household out-of-pocket (OOP) expenses associated with the illness will be presented for the study population. An equity analysis will be performed by disaggregating and comparing mean/median OOP costs across wealth quintiles, sex, geographical location, parental education and ethnic groups.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Children aged 1 month - 14 years 11 months with a severe illness/injury
Children aged 1 month - 14 years 11 months presenting to hospital with symptoms of an acute "severe" illness/injury that started within the last 2 weeks. "Severe" defined as a child showing emergency signs or requiring hospital admission for treatment.
No intervention
This is an observational study with no intervention
Interventions
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No intervention
This is an observational study with no intervention
Eligibility Criteria
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Inclusion Criteria
* Child presents to or is admitted to hospital at one of the participating study site hospitals within the time period of the study
* Child presents with symptoms of acute illness that started within the last 2 weeks (14 days) prior to hospital presentation. This will include children with a chronic illness but with new onset of symptoms within last 2 weeks.
* Child is assessed by a health officer at the participating study site hospital and is deemed to have a "severe" illness/injury. A "severe" illness/injury will be defined as a child showing any emergency signs as outlined in the WHO Pocketbook, second edition:
OR Requires hospital admission/transfer to another health facility for further investigations and/or treatment for their acute illness/injury that cannot be performed in an outpatient setting or ED. This may include but is not limited to: transfer to another hospital with intensive care unit (ICU), intravenous (IV) medication or fluids; enteral nutrition; oxygen therapy; surgery.
• Parent/guardian has provided written informed consent, and will be available for the duration of the study follow-up period.
Exclusion Criteria
* Child with symptoms that started \>2 weeks (\>14 days) prior to hospital presentation
* Child admitted to the neonatal intensive care unit (NICU)
* Child admitted to hospital for a planned procedure or planned treatment of a chronic medical condition (eg. Tonsillectomy, replacement of ventriculoperitoneal shunt or percutaneous endoscopic gastronomy (PEG) tube, tune up for cystic fibrosis, chemotherapy, palliative care),
* Child already enrolled into this study from a previous hospital admission
* Child discharged prior to screening and informed consent processes by study team members.
1 Month
15 Years
ALL
No
Sponsors
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Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit
OTHER
Murdoch Childrens Research Institute
OTHER
Responsible Party
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Principal Investigators
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Fiona Russell, BMBS FRACP MPHTM PhD
Role: PRINCIPAL_INVESTIGATOR
Murdoch Childrens Research Institute
Locations
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Lao-Oxford-Mahosot-Hospital Wellcome Trust Research Unit (LOMWRU)
Vientiane, , Laos
Countries
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References
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Zhang S, Sammon PM, King I, Andrade AL, Toscano CM, Araujo SN, Sinha A, Madhi SA, Khandaker G, Yin JK, Booy R, Huda TM, Rahman QS, El Arifeen S, Gentile A, Giglio N, Bhuiyan MU, Sturm-Ramirez K, Gessner BD, Nadjib M, Carosone-Link PJ, Simoes EA, Child JA, Ahmed I, Bhutta ZA, Soofi SB, Khan RJ, Campbell H, Nair H. Cost of management of severe pneumonia in young children: systematic analysis. J Glob Health. 2016 Jun;6(1):010408. doi: 10.7189/jogh.06.010408.
Barennes H, Frichittavong A, Gripenberg M, Koffi P. Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic. PLoS One. 2015 Sep 1;10(9):e0136664. doi: 10.1371/journal.pone.0136664. eCollection 2015.
Wagstaff A, Flores G, Hsu J, Smitz MF, Chepynoga K, Buisman LR, van Wilgenburg K, Eozenou P. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health. 2018 Feb;6(2):e169-e179. doi: 10.1016/S2214-109X(17)30429-1. Epub 2017 Dec 13.
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Grepin KA, Irwin BR, Sas Trakinsky B. On the Measurement of Financial Protection: An Assessment of the Usefulness of the Catastrophic Health Expenditure Indicator to Monitor Progress Towards Universal Health Coverage. Health Syst Reform. 2020 Dec 1;6(1):e1744988. doi: 10.1080/23288604.2020.1744988.
Memirie ST, Metaferia ZS, Norheim OF, Levin CE, Verguet S, Johansson KA. Household expenditures on pneumonia and diarrhoea treatment in Ethiopia: a facility-based study. BMJ Glob Health. 2017 Jan 18;2(1):e000166. doi: 10.1136/bmjgh-2016-000166. eCollection 2017.
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Barasa EW, Ayieko P, Cleary S, English M. Out-of-pocket costs for paediatric admissions in district hospitals in Kenya. Trop Med Int Health. 2012 Aug;17(8):958-61. doi: 10.1111/j.1365-3156.2012.03029.x. Epub 2012 Jun 21.
Sultana M, Alam NH, Ali N, Faruque ASG, Fuchs GJ, Gyr N, Chisti MJ, Ahmed T, Gold L. Household economic burden of childhood severe pneumonia in Bangladesh: a cost-of-illness study. Arch Dis Child. 2021 Jun;106(6):539-546. doi: 10.1136/archdischild-2020-320834. Epub 2021 Apr 27.
Alamgir NI, Naheed A, Luby SP. Coping strategies for financial burdens in families with childhood pneumonia in Bangladesh. BMC Public Health. 2010 Oct 19;10:622. doi: 10.1186/1471-2458-10-622.
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Other Identifiers
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81864
Identifier Type: -
Identifier Source: org_study_id
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