{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:06:36Z","timestamp":1789034796334,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,6,25]],"date-time":"2017-06-25T00:00:00Z","timestamp":1498348800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T00:00:00Z","timestamp":1475712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Chronic Diseases and Translational Medicine"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to investigate the distribution of chronic illness and associated disability, out\u2010of\u2010pocket payment (OOPP), and other related factors using survey data from Bangladesh.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed Bangladesh Household Income and Expenditure Survey data that include socio\u2010economic and demographic data, such as consumption, expenditures, and assets, along with information regarding chronic illness and disability. Multiple linear regression models were used to identify factors significantly associated with OOPP. Furthermore, a binary Logistic regression model was employed to assess the association of the explanatory variables with disability status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A higher prevalence of chronic illness was found for those with chronic gastritis (18.70%), and 41.92% of the population had at least one side disability. The average OOPP healthcare expenditure for chronic illness was estimated to be US$7.59. Higher OOPP was found among the upper 2 wealth quintiles. Overall OOPP health expenditure was significantly higher among individuals with an associated disability (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The likelihood of having an associated disability was higher among those individuals with a lower education level (<jats:italic>OR<\/jats:italic>\u00a0=\u00a02.36, 95% <jats:italic>CI<\/jats:italic>: 1.95\u20134.06), those who not earning an income (<jats:italic>OR<\/jats:italic>\u00a0=\u00a02.85, 95% <jats:italic>CI<\/jats:italic>: 2.53\u20133.21), those who did not seek care (<jats:italic>OR<\/jats:italic>\u00a0=\u00a01.73, 95% <jats:italic>CI<\/jats:italic>: 1.57\u20131.90), those who sought care from a pharmacy (<jats:italic>OR<\/jats:italic>\u00a0=\u00a08.91, 95% <jats:italic>CI<\/jats:italic>: 7.38\u201310.74), and those in the lowest wealth quintile (<jats:italic>OR<\/jats:italic>\u00a0=\u00a07.21, 95% <jats:italic>CI<\/jats:italic>: 6.41\u20138.12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high OOPP illustrates the necessity of financial risk protection for the population at low socio\u2010economic status. Therefore, we recommend that the government strengthen the healthcare system with appropriate support directed to the rural and elderly populations.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.cdtm.2017.02.001","type":"journal-article","created":{"date-parts":[[2017,4,17]],"date-time":"2017-04-17T12:30:48Z","timestamp":1492432248000},"page":"112-122","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"title":["Burden of chronic illness and associated disabilities in Bangladesh: Evidence from the Household Income and Expenditure Survey"],"prefix":"10.1002","volume":"3","author":[{"given":"Marufa","family":"Sultana","sequence":"first","affiliation":[{"name":"Health Economics and Financing Research Health Systems and Population Studies Division International Centre for Diarrhoeal Disease Research Bangladesh (icddr'b) Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidul Alam","family":"Mahumud","sequence":"additional","affiliation":[{"name":"Health Economics and Financing Research Health Systems and Population Studies Division International Centre for Diarrhoeal Disease Research Bangladesh (icddr'b) Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdur Razzaque","family":"Sarker","sequence":"additional","affiliation":[{"name":"Health Economics and Financing Research Health Systems and Population Studies Division International Centre for Diarrhoeal Disease Research Bangladesh (icddr'b) Dhaka Bangladesh"},{"name":"University of Strathclyde Glasgow United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4505-11-31"},{"key":"e_1_2_11_3_1","unstructured":"GBD 2015 Mortality and Causes of Death Collaborators.Global regional and national life expectancy all\u2010cause mortality and cause\u2010specifi c mortality for 249 causes of death 1980 \u2013 2015: a systematic analysis for the Global Burden of Disease Study 2015388:2016;1459\u20131544"},{"key":"e_1_2_11_4_1","unstructured":"WHO.Global Status Report on Non\u2010communicable Diseases 2010.2011 Geneva Switzerland. Available at:http:\/\/www.who.int\/nmh\/publications\/ncd_report_full_en.pdf?ua=1"},{"key":"e_1_2_11_5_1","first-page":"1","article-title":"Chronic non\u2010communicable diseases and the healthcare system in Bangladesh: current status and way forward","volume":"1","author":"Islam A.","year":"2014","journal-title":"Chronic Dis Int"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","unstructured":"Plianbangchang S Narain JP.Health situation in the South\u2010East Asia Region: challenges for the next decade.WHO South East Asia J Public Health.http:\/\/www.searo.who.int\/LinkFiles\/SEAJPH_SEAJPH\u20101\u20101.pdf. Published 2012.","DOI":"10.4103\/2224-3151.206905"},{"key":"e_1_2_11_7_1","first-page":"117","volume-title":"Global Burden of Disease and Injury Series. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020","author":"Murray C.J.L.","year":"1996"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61829-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.09.004"},{"key":"e_1_2_11_10_1","first-page":"1","article-title":"Epidemiological transition in rural Bangladesh, 1986\u20102006","volume":"2","author":"Karar Z.A.","year":"2009","journal-title":"Glob Health Action"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-1008"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv234"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.6.267"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056873"},{"key":"e_1_2_11_15_1","unstructured":"World Health Organization. WHO Global Health Expenditure Atlas. Geneva Switzerland 2014. Available at:http:\/\/www.who.int\/health\u2010accounts\/atlas2014.pdf."},{"key":"e_1_2_11_16_1","volume-title":"Expanding Social Protection for Health: Towards Universal Coverage, Health Care Financing Strategy 2012\u20132032","author":"MOHFW","year":"2012"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150131914540916"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103681"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1551"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2011.02836.x"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"e0116897","DOI":"10.1371\/journal.pone.0116897","article-title":"Out\u2010of\u2010pocket expenditure on chronic non\u2010communicable diseases in Sub\u2010Saharan Africa: the case of Rural Malawi","volume":"10","author":"Wang Q.","year":"2015","journal-title":"PLoS One"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2014-204960"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69560-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1209"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-015-0134-6"},{"key":"e_1_2_11_26_1","unstructured":"BBS (Bangladesh Bureau of Statistics).Bangladesh Household Income and Expenditure Survey 2010 Statistics Division Ministry of Planning. Government of the People's Republic of Bangladesh: New Panama Printing Press2011 Available at:http:\/\/203.112.218.65\/WebTestApplication\/userfiles\/Image\/LatestReports\/HIES\u201010.pdf. Accessed 20 January 2017"},{"issue":"4","key":"e_1_2_11_27_1","first-page":"1","article-title":"Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability Statistics","volume":"11","author":"Madans J.H.","year":"2011","journal-title":"BMC Public Health"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0898264313501388"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/2193-1801-3-435"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-451"},{"key":"e_1_2_11_31_1","unstructured":"WHO.Global Status Report on Noncommunicable Diseases 2014. Geneva Switzerland.2014 Available at:http:\/\/apps.who.int\/iris\/bitstream\/10665\/148114\/1\/9789241564854_eng.pdf."},{"key":"e_1_2_11_32_1","first-page":"45","article-title":"Morbidity pattern among the elderly population in the Rural Area of Tamilnadu, India","volume":"36","author":"Purty A.J.","year":"2006","journal-title":"Turk Jr Med Sci"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg204"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2008.tb01919.x"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0127199"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt191"},{"key":"e_1_2_11_37_1","volume-title":"Sick Societies: Responding to the Global Challenge of Chronic Disease","author":"Stuckler D.","year":"2013"},{"key":"e_1_2_11_38_1","first-page":"e08","article-title":"Caring for people with chronic conditions: a health system perspective","volume":"9","author":"Nolte E.E.","year":"2009","journal-title":"Int J Integr Care"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-89"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmr013"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1363"},{"key":"e_1_2_11_42_1","unstructured":"R.A.P.Mbchb G.A.Abel B.G.Mbbchir S.W.M.Mbchb.Admissions to hospital: a retrospective cohort study;185(5):2013;1\u20138.10.1503\/cmaj.121349\/\u2010\/DC1"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-38"}],"container-title":["Chronic Diseases and Translational Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2095882X16300895?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2095882X16300895?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.cdtm.2017.02.001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.cdtm.2017.02.001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.cdtm.2017.02.001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T12:37:57Z","timestamp":1693139877000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.cdtm.2017.02.001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1016\/j.cdtm.2017.02.001"],"URL":"https:\/\/doi.org\/10.1016\/j.cdtm.2017.02.001","archive":["Portico"],"relation":{},"ISSN":["2589-0514","2589-0514"],"issn-type":[{"value":"2589-0514","type":"print"},{"value":"2589-0514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Burden of chronic illness and associated disabilities in Bangladesh: Evidence from the Household Income and Expenditure Survey","name":"articletitle","label":"Article Title"},{"value":"Chronic Diseases and Translational Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cdtm.2017.02.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.","name":"copyright","label":"Copyright"}]}}