Perception of Availability, Accessibility, and Affordability of COVID-19 Vaccines and Hesitancy: A Cross-Sectional Study in India

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Result: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes

Effect of healthcare expenditure on the health related quality of life among diabetic patients of South India: A cross- sectional study

Background: Diabetes mellitus imposes a huge economic burden along with impairing health related quality of life (HRQoL) among patients. The purpose of this study was to determine the effect of healthcare expenditure on HRQoL among diabetic patients. Methods: A Cross -Sectional study was carried out among 328 Type 2 diabetics in Southern India. HRQoL was assessed using EQ-5D-5L questionnaire and data regarding expenditure were gathered using a validated questionnaire. Poisson regression and Multivariate regression analysis were performed to predict the factors associated with healthcare expenditure and quality of life respectively. Results: The annual expenditure in management of diabetes was INR 10969.6 (USD 132.83) with direct medical cost INR 8727 (USD 105.67) forming the bulk. 11.6% of participants spent over 30% of their annual income in diabetes care. Older age group, being obese, lower socioeconomic status, longer duration of diabetes, presence of complication, episodes of hospitalization were associated with higher healthcare expenditure. Mean quality of life score was 0.84 ± 0.13 and mean visual analog score was 73.15 ± 11.21. Participants with EQ-5D-5L index of range (0.0–0.3) had an expenditure of INR 31703.56. On linear regression analysis, proportion of total income spent for diabetes care was associated with poor quality of life (β = −0.163, 95% CI = −0.239 to −0.086, p < 0.001). Conclusion: Cost of diabetes care was inordinately high and an increased spending particularly among the socioeconomically disadvantaged group, resulting in poorer QoL. Policymakers need to focus on strengthening primary healthcare facilities for Non-Communicable diseases and implementing cost containment policy for reducing the financial burden