Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys

Abstract

This study examines catastrophic health expenditures and the potential for such payments to impoverish South African households. The analysis applies three different catastrophic expenditure measurements, and we apply them across four South African Income and Expenditure Surveys. Since households have limited resources, they are also limited in their capacity to purchase health care. Thus, if a household devotes a large share of that capacity to health care, it may not be able to cover other necessary expenses, which could be catastrophic. The measurements differ in their definition of household capacity. Despite the differences in measurements, and, therefore, results, we find limited incidence of health care expenditure catastrophe, although larger shares of capacity are being devoted to health care in more recent years. In line with the finding that catastrophe is rare, we find that very few households are subsequently impoverished, because of health care costs.

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

“…In Nigeria, OOP payments contribute over 70% of the spending on health, significantly surpassing the recommended 30% threshold [7,8]. This percentage is among the highest in the world, and certainly the highest in Africa, bringing financial ruin to many family circles [7,8].…”

“…In Nigeria, OOP payments contribute over 70% of the spending on health, significantly surpassing the recommended 30% threshold [7,8]. This percentage is among the highest in the world, and certainly the highest in Africa, bringing financial ruin to many family circles [7,8]. Nigeria has established remarkable but unspecified significant commitments to decreasing OOP in order to ensure increased access of citizens to quality primary healthcare services by ratifying into law the National Health Act in 2014.…”

Assessing the Impact of Out-of-Pocket Expenditures for Prevention of COVID-19 Infection on Households: Evidence From Malaysia

“…It would include buying for a face-mask or any preventive tool, user fees and co-payments, over-the-counter and prescription drugs, as well as doctor fees, hospital costs and related charges. 12…”

Effect of the Ghana National Health Insurance Scheme on exit time from catastrophic healthcare expenditure

“…Exit time from CHE is the average time an individual or a household facing CHE will exit the CHE (Mussa, 2014). Though many studies have focused on CHE (see Aryeetey et al, 2016; Kimani & Maina, 2015; Koch & Setshegetso, 2020; Wagstaff et al, 2018); we have little evidence on exit time from CHE (see Mussa, 2014). Other factors held constant, the longer (shorter) it takes a household to exit CHE the more (less) severe is the CHE.…”