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The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.

The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.

The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.

The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

This study aimed to determine mothers' knowledge of children with congenital heart disease (CHD) and to examine the relationship between types of CHD, the duration of treatments, the perception of the severity of illness and the mothers' knowledge.

A correlation study was conducted among 84 mothers of children (from infancy to six years old) with CHD who had attended pediatric cardiology clinics and pediatric units in three tertiary hospitals in Bangkok, Thailand. The two questionnaires aimed to evaluate the mothers' knowledge and perceptions of the severity of illness. Descriptive statistics, Spearman's rank-order correlation and Fisher's exact test were used to analyze the data.

Knowledge levels of mothers of children with CHD were at a high level with a mean score of 34.79 (SD = 8.23), but the knowledge domain of preventing complications was at a low level with a mean score of 14.95 (SD = 5.28). The types of CHD and the perceptions of illness were not correlated with the mothers' knowledge, but the duration of treatments was significantly correlated (r = 0.271, p < 0.05).

Healthcare professionals, especially nurses, should emphasize proper health education on complication prevention and the duration of treatments for children. Moreover, mothers should be supported to nurture children with CHD to reduce possible complications and prepare for cardiac surgery where needed.

The objective of this study was to examine the causal relationships among sex, social support, disease severity, symptoms, physical activity, general health perception and health-related quality of life (HRQOL) in Thai adolescents with congenital heart disease (CHD).

A cross-sectional study was conducted using convenience sampling to recruit 200 Thai adolescents with CHD aged between 13 and18 years from four tertiary university hospitals in Bangkok. Interview method and self-administered questionnaires were used for data collection held between November 2018 and February 2019. Data were analyzed using path analysis to test the hypothesized model of the relationships.

The causal model of HRQOL revealed a good fit with the data. This model of relationship could explain 48% of the variances in HRQOL. Only direct effects of disease severity, symptoms and social support on HRQOL were found while indirect effects were not.

Due to the lack of study focusing on factors influencing HRQOL in Thai adolescents with CHD, this empirical study provides the evidence in Thai literature. The modifiable influencing factors for HRQOL found in this study can be manipulated through psycho-educational intervention given to the adolescents and significant others, especially parents, to help increase quality of life in adolescents with CHD.

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

The substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.

A systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.

Chronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.

The present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.

Given the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.