DHS-8-PGSSC-Total_Household_Expenditure-Template [message #16801] |
Tue, 05 March 2019 17:28 |
PGSSC
Messages: 10 Registered: March 2019 Location: Boston, USA
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The questions we propose are a product of the Lancet Commission on Global Surgery (LCoGS), a body of work spanning three years involving 25 commissioners and a diverse group of academic, governmental and civil society collaborators from 110 countries. Of the six indicators proposed by the LCoGS, four were published in the World Development Indicators by the World Bank and all six are included in the World Health Organization's Global Reference List of 100 Core Health Indicators. Nevertheless, there currently are no mechanisms in place to collect the data required for these indicators, creating a critical gap in knowledge for surgical care strengthening.
The new indicators in this proposal span four existing DHS modules. For clarity, they are listed in the table below. Of particular interest are the questions on out-of-pocket expenditure and household expenditure to enable the calculation of financial risk protection for all medical interventions captured by the DHS (both surgical and medical), a core component of Sustainable Development Goal 3.8. The remaining questions were taken from a successful pilot DHS survey in Zambia. In the development of this application, we have been fortunate to count on a number of international partners to provide expert review and the indicators proposed are a culmination of these consensus building discussions. Please refer to Appendix A for a full list of international stakeholders who support this application.
Proposed Indicators:
1. Risk of impoverishing and catastrophic expenditure
Data Utility:
1. World Bank: World Development Indicators
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Re: DHS-8-PGSSC-Total_Household_Expenditure-Template [message #17232 is a reply to message #16801] |
Fri, 15 March 2019 16:20 |
shrime
Messages: 3 Registered: March 2019
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Universal health coverage is more than just making sure people get care. It's making sure that care doesn't impoverish them. Without data about their household expenditures, the global community cannot work to prevent the impoverishment that patients face when accessing care
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Re: DHS-8-PGSSC-Total_Household_Expenditure-Template [message #17247 is a reply to message #16801] |
Fri, 15 March 2019 16:25 |
bat1117
Messages: 1 Registered: March 2019
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The devastating overall impact, specifically emotional and financial, of trauma, necessary surgery and post-operative care persists far beyond the incident or progressing and mounting episodes. I believe we all agree. Are there plans to develop systems and programs that support ongoing post-operative policies that will provide patients (lower income patients) centralized (or even decentralized) healthcare information services to which they can access for questions and concerns after their surgery has been completed? May I recommend that such "tertiary services" be debated in terms of the long-term benefit for surgical patients and families. The surgical costs, being relatively enormous, at this time, might preclude lower/middle income patients and families from seeking ongoing more long-term care information from fear of driving up personal costs. If sustainable post-operative health care "information-access" systems and services were available for these populations, overall healing and survival might demonstrate increases and the costs for delays in accessing care could be averted.
I commend the valiant efforts of global surgical advocates and it is an honor to serve with any of them. Nevertheless, I advocate that surgical efforts for ALL lower income patients result in success. Providing health information and responding to surgical patient questions (without driving) up post-operative costs seems achievable though an innovative systems approach.
Please, consider the value of post-operative health and care information access systems. The long-term payoff for sequential informaition systems and services could be powerful!
[Updated on: Fri, 15 March 2019 16:27] Report message to a moderator
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Re: DHS-8-PGSSC-Total_Household_Expenditure-Template [message #17327 is a reply to message #16801] |
Fri, 15 March 2019 17:43 |
Dr. Ernest Barthélemy
Messages: 6 Registered: March 2019
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As an American neurosurgeon working in Haiti, I have been in the unfortunate position of witnessing families refusing life-saving interventions for their sick family members because of fear that the cost of these interventions would financially ruin the entire family. In this uniquely low-income country in the Americas, understanding and tracking the risk of impoverishing and catastrophic expenditure is an absolutely essential part of strengthening the health system through scale-up of surgical capacity. I therefore wholeheartedly support the inclusion of this indicator in the DHS.
PGSSC wrote on Tue, 05 March 2019 17:28The questions we propose are a product of the Lancet Commission on Global Surgery (LCoGS), a body of work spanning three years involving 25 commissioners and a diverse group of academic, governmental and civil society collaborators from 110 countries. Of the six indicators proposed by the LCoGS, four were published in the World Development Indicators by the World Bank and all six are included in the World Health Organization's Global Reference List of 100 Core Health Indicators. Nevertheless, there currently are no mechanisms in place to collect the data required for these indicators, creating a critical gap in knowledge for surgical care strengthening.
The new indicators in this proposal span four existing DHS modules. For clarity, they are listed in the table below. Of particular interest are the questions on out-of-pocket expenditure and household expenditure to enable the calculation of financial risk protection for all medical interventions captured by the DHS (both surgical and medical), a core component of Sustainable Development Goal 3.8. The remaining questions were taken from a successful pilot DHS survey in Zambia. In the development of this application, we have been fortunate to count on a number of international partners to provide expert review and the indicators proposed are a culmination of these consensus building discussions. Please refer to Appendix A for a full list of international stakeholders who support this application.
Proposed Indicators:
1. Risk of impoverishing and catastrophic expenditure
Data Utility:
1. World Bank: World Development Indicators
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Re: DHS-8-PGSSC-Total_Household_Expenditure-Template [message #17400 is a reply to message #17395] |
Fri, 15 March 2019 22:27 |
IsaacWasserman
Messages: 8 Registered: March 2019
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As powerful as modeling studies are, the only way to progress past the realm of the theoretical, and anchor ourselves in the realm of the real is to collect robust data. When surgery playing a role in nearly 1/3rd of all human disease, I can think of no better area to invest in better data collection. This will help evaluate ongoing projects, as well as steer new ones. Thank you for expanding into this important sphere.
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