Related Experiment Video
Updated: Dec 7, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Healthcare utilisation and expenditure patterns for cardio-metabolic diseases in South Asian cities: the CARRS Study
Priti Gupta1, Kalpana Singh2, Roopa Shivashankar2
1Centre for Chronic Disease Control, New Delhi, India priti2317@gmail.com.
Insights
Cardio-metabolic diseases (CMDs) incur substantial economic burdens in South Asia. High out-of-pocket spending and limited insurance increase the risk of distress financing for treatments.
Area of Science:
- Public Health
- Health Economics
- Epidemiology
Background:
- Cardio-metabolic diseases (CMDs) represent a growing health challenge in South Asia.
- Estimating the economic impact of CMDs is crucial for policy development and resource allocation.
Purpose of the Study:
- To estimate per-person expenditures, total economic burden, and distress financing associated with treating five major CMDs in three South Asian metropolitan cities.
- To identify sociodemographic factors contributing to distress financing.
Main Methods:
- Cross-sectional survey data from the CARRS Study (2010-2011) in Chennai, New Delhi, and Karachi.
- Analysis of cost-of-illness questionnaires from adults (≥20 years) receiving CMD treatment.
- Projection of total economic burden using age-standardized prevalence and per-person costs.
Main Results:
- Annual expenditures per patient ranged from Int$358 to Int$2425, with medications comprising 46% of direct costs.
- Total economic burdens were Int$0.42 billion (Chennai), Int$3.4 billion (New Delhi), and Int$1.4 billion (Karachi).
- 36.1% of patients experienced distress financing; women, the unemployed, and the uninsured faced significantly higher odds.
Conclusions:
- CMDs impose significant economic burdens across South Asian cities.
- High out-of-pocket expenditures and limited insurance coverage contribute to a high prevalence of distress financing for CMD treatment.
Objective:
To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia.
Design:
Cross-sectional surveys.
Setting:
We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan).
Participants:
We used data from non-pregnant adults (≥20 years) from the aforementioned cities that responded to a cost-of-illness questionnaire. We estimated health utilisation and expenditures among those reporting taking treatment(s) for the aforementioned CMDs in the last 1 year. We converted all costs to International Dollars (Int$ 2011) and inflated to 2018 values. The annual costs per person were stratified by city, sociodemographic characteristics, contributor of costs and financing methods. The total economic burden of CMDs for each city was projected using age-standardised prevalence and per-person costs of diseases reported in CARRS, applying these to population data from the most recent census. We also calculated distress financing (DF) as having to borrow or sell assets to pay for CMD treatment and identified sociodemographic groups at most risk of DF using multiple regression.
Results:
Of 16 287 CARRS participants, 2883 (17.7%) reported receiving treatment for CMDs. The total annual expenditures reported per patient for CMDs ranged from Int$358 to Int$2425. Medications constituted 46% of total direct expenditures and out-of-pocket (OOP) expenditures accounted for nearly 80% of financing these health expenditures. Total economic burdens of CMDs were Int$0.42 billion, Int$3.4 billion and Int$1.4 billion in Chennai, New Delhi and Karachi, respectively. Overall, 36.1% experienced DF, and women (OR=4.4), unemployed (OR=10.7) and uninsured (OR=8.1) adults experienced higher odds of DF.
Conclusion:
CMDs are associated with large economic burdens in South Asia. Due to most payments coming from OOP expenditures and limited insurance, the odds of DF are high.
Related Concept Videos
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:30Coronary Artery Disease I: Introduction
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:27Coronary Artery Disease V: Interprofessional Care
01:26Coronary Artery Disease IV: Preventive Measures