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The burden of chronic diseases, disease-stratified exploration and gender-differentiated healthcare utilisation among patients in Bangladesh

Author

Listed:
  • Rashidul Alam Mahumud
  • Jeff Gow
  • Md Parvez Mosharaf
  • Satyajit Kundu
  • Md Ashfikur Rahman
  • Natisha Dukhi
  • Md Shahajalal
  • Sabuj Kanti Mistry
  • Khorshed Alam
Abstract
Background: Chronic diseases are considered one of the major causes of illness, disability, and death worldwide. Chronic illness leads to a huge health and economic burden, especially in low- and middle-income countries. This study examined disease-stratified healthcare utilisation (HCU) among Bangladesh patients with chronic diseases from a gender perspective. Methods: Data from the nationally representative Household Income and Expenditure Survey 2016–2017 consisting of 12,005 patients with diagnosed chronic diseases was used. Gender differentiated chronic disease stratified-analytical exploration was performed to identify the potential factors to higher or lower utilisation of healthcare services. Logistic regression with step-by-step adjustment for independent confounding factors was the method used. Results: The five most prevalent chronic diseases among patients were gastric/ulcer (Male/Female, M/F: 16.77%/16.40%), arthritis/rheumatism (M/F: 13.70%/ 13.86%), respiratory diseases/asthma/bronchitis (M/F: 12.09% / 12.55%), chronic heart disease (M/F: 8.30% / 7.41%), and blood pressure (M/F: 8.20% / 8.87%). Eighty-six percent of patients with chronic diseases utilised health care services during the previous 30 days. Although most patients received outpatient healthcare services, a substantial difference in HCU among employed male (53%) and female (8%) patients were observed. Chronic heart disease patients were more likely to utilise health care than other disease types, which held true for both genders while the magnitude of HCU was significantly higher in males (OR = 2.22; 95% CI:1.51–3.26) than their female counterparts (OR = 1.44; 1.02–2.04). A similar association was observed among patients with diabetes and respiratory diseases. Conclusion: A burden of chronic diseases was observed in Bangladesh. Patients with chronic heart disease utilised more healthcare services than patients experiencing other chronic diseases. The distribution of HCU varied by patient’s gender as well as their employment status. Risk-pooling mechanisms and access to free or low-cost healthcare services among the most disadvantaged people in society might enhance reaching universal health coverage.

Suggested Citation

  • Rashidul Alam Mahumud & Jeff Gow & Md Parvez Mosharaf & Satyajit Kundu & Md Ashfikur Rahman & Natisha Dukhi & Md Shahajalal & Sabuj Kanti Mistry & Khorshed Alam, 2023. "The burden of chronic diseases, disease-stratified exploration and gender-differentiated healthcare utilisation among patients in Bangladesh," PLOS ONE, Public Library of Science, vol. 18(5), pages 1-17, May.
    • Handle: RePEc:plo:pone00:0284117
    DOI: 10.1371/journal.pone.0284117
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    References listed on IDEAS

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    1. Roy, Kakoli & Chaudhuri, Anoshua, 2008. "Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India," Social Science & Medicine, Elsevier, vol. 66(9), pages 1951-1962, May.
    2. Nandita Saikia & Moradhvaj & Jayanta Kumar Bora, 2016. "Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    3. Bleich, Sara N. & Koehlmoos, Tracey L.P. & Rashid, Mashida & Peters, David H. & Anderson, Gerard, 2011. "Noncommunicable chronic disease in Bangladesh: Overview of existing programs and priorities going forward," Health Policy, Elsevier, vol. 100(2), pages 282-289.
    4. Bleich, Sara N. & Koehlmoos, Tracey L.P. & Rashid, Mashida & Peters, David H. & Anderson, Gerard, 2011. "Noncommunicable chronic disease in Bangladesh: Overview of existing programs and priorities going forward," Health Policy, Elsevier, vol. 100(2-3), pages 282-289, May.
    5. Mondal, Bidisha & Dubey, Jay Dev, 2020. "Gender discrimination in health-care expenditure: An analysis across the age-groups with special focus on the elderly," Social Science & Medicine, Elsevier, vol. 258(C).
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