<sec>
<title>Objectives</title>
<p>Cardiovascular disease (CVD) has a substantial financial impact on healthcare systems in the US. This study aimed to examine the impact of CVD on health insurance coverage and health service use under economic stress as indicated by the Great Recession in the US (December 2007–June 2009).</p></sec>
<sec>
<title>Methods</title>
<p>Data of 26,483 adults aged ≥ 20 years from the 2003–2012 National Health and Nutrition Examination Survey were analyzed. There were 9,479 adults assigned to the group “before the Great Recession” (2003–2006), 5,674 adults assigned to “during the Great Recession” (2007–2008), and 11,330 adults assigned to “after the Great Recession” (2009–2012).</p></sec>
<sec>
<title>Results</title>
<p>Patients with CVD from low-income families were more likely to have health insurance during the recession (OR:1.57, 95% CI: 1.01,2.45). Those participants without CVD, who were from low-income families or < 65 years, were more likely to use the emergency room rather than primary care facilities to gain access to routine healthcare (<italic>p</italic> < 0.05). Patients with CVD from high-income families were also more likely to use the emergency room (<italic>p</italic> < 0.05). Patients with CVD but not those without CVD, who reported a high family income or were ≥ 65 years old, were less likely to use mental health services during the recession than before the recession.</p></sec>
<sec>
<title>Conclusion</title>
<p>Effective strategies need to be developed to promote primary care use among the general adult American population. In addition, use of mental health services among patients with CVD needs to be improved when financial stress occurs.</p></sec>
<sec>
<title>Objectives</title>
<p>Hand, Foot and Mouth disease (HFMD) is a highly contagious viral disease that affects young children and frequently causes epidemics. A vaccine is available in China (enterovirus 71) and, the Republic of Korea took the first step to develop a new vaccine. New vaccine development requires that disease burden is calculated in advance so the financial cost, morbidity and mortality can be measured.</p></sec>
<sec>
<title>Methods</title>
<p>Data from National Sentinel Surveillance and health insurance systems of 1 million claimants were used. Direct medical and non-medical costs, indirect (caregiving and premature death) costs, cases and related deaths were summarized.</p></sec>
<sec>
<title>Results</title>
<p>From 2010 to 2014, there were an estimated 3,605 to 9,271 cases of HFMD, with 1 to 3 deaths. The estimated socioeconomic disease burden ranged from 80.5 to 164.2 million USD and was similar to that of hepatitis A (93.6–103.8 million USD). Among each costs, costs of caregiving consisted of highest proportion mainly due to hiring caregivers (50% – 60%) or opportunity costs from day off (62% – 69%).</p></sec>
<sec>
<title>Conclusion</title>
<p>Considering the social impact of HFMD, the estimated socioeconomic disease burden is not high and government policies need to focus on reducing the loss of work in caregivers.</p></sec>
Citations
Citations to this article as recorded by
How urbanization shapes the effectiveness of school closures on hand, foot, and mouth disease Yazhen Zhang, Juan Zhang, Xuefeng Zhang, Hui Jin International Journal of Infectious Diseases.2025; 154: 107845. CrossRef
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The Hand, Foot, and Mouth Disease Sentinel Surveillance System in South Korea: Retrospective Evaluation Study Bryan Inho Kim, Chiara Achangwa, Seonghui Cho, Jisoo Ahn, Jisu Won, Hyunkyung Do, Dayeong Lee, Bohye Yoon, Joohee Kim, Sukhyun Ryu JMIR Public Health and Surveillance.2024; 10: e59446. CrossRef
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A reaction-diffusion HFMD model with nonsmooth treatment function Lei Shi, Hongyong Zhao, Daiyong Wu Advances in Difference Equations.2021;[Epub] CrossRef
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Application of a combined model with seasonal autoregressive integrated moving average and support vector regression in forecasting hand-foot-mouth disease incidence in Wuhan, China Jiao-Jiao Zou, Gao-Feng Jiang, Xiao-Xu Xie, Juan Huang, Xiao-Bing Yang Medicine.2019; 98(6): e14195. CrossRef
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