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UPJ INSIGHT: Economic Impact of Urological Conditions in Men and Women in Belize
By: Clinton Yeaman, MD, MS; Raj Desai, MS; Devang Sharma, MD; Jacqueline Zillioux, MD; Rajesh Balkrishnan, PhD; David E. Rapp, MD | Posted on: 01 Dec 2022
Yeaman C, Desai R, Sharma D, Zillioux J, Balkrishnan R, Rapp DE. Economic impact of urological conditions in men and women in Belize. Urol Pract. 2022;9(6):543-549.
Study Need and Importance
The Lancet Commission on Global Surgery called for promotion of widespread access to safe and affordable surgical care worldwide, as many people lack such access globally. While we understand the clinical need for urological care, little is known about the microeconomic impacts of urological disease on patients in low- and middle-income countries (LMICs). To this end, we performed a survey-based study of the work time missed, impairment while at work, and overall impairment caused by urological diseases in Belize, where we provide urological care on an ongoing basis.
What We Found
Our study demonstrated that 87% of patients endorse a negative impact of their urological disease on their life and significant difficulty performing caretaking responsibilities. Eighty-eight percent state that cure of their urological disease would improve their ability to care for their family and improve job performance, as shown in the Table. Of those who had to take time off work for urological health problems, urological disease resulted in a loss of a median of 55% of income.
Table. Questionnaire Responses on Impact of Urological Disease on Work and Caregiving
| All patients, No. (%) (N = 114) | No financial data, No. (%) (n = 53) | Financial cohort, No. (%) (n = 61) | P Valuea | |
|---|---|---|---|---|
| Negative impact on life | 100 (87.7) | 45 (84.9) | 55 (90.2) | .57 |
| Problems caring for family | 42 (37.2) | 21 (39.6) | 21 (34.4) | .71 |
| Cause for negative impact | ||||
| Pain | 77 (67.5) | 37 (69.8) | 40 (65.6) | .74 |
| Embarrassment | 38 (33.3) | 19 (35.8) | 19 (31.1) | .78 |
| Time off work | 36 (31.6) | 9 (17.0) | 27 (44.3) | .003 |
| Time for doctor’s visits | 53 (46.5) | 20 (37.3) | 33 (54.1) | .12 |
| UD treatment would improve family care or job performance | 101 (88.6) | 47 (88.6) | 54 (88.5) | 1.00 |
| Abbreviation: UD, urological disease. aCompares financial and no financial data cohorts. |
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Limitations
Our study is limited by the small sample size of patients and issues of enrollment related to the COVID-19 pandemic. This study was conducted in a single LMIC, Belize, which limits generalizability of the results to a global scale; however, many of the inherent issues related to urological care would translate across populations.
Interpretation for Patient Care
Urological diseases result in significant work impairment and lost income. In order to best serve the global community, efforts to improve access to urological surgery in LMICs are important and would promote benefits to patient’s quality of life but also economic health and ability to care for their families.
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