Catastrophic health payments and health insurance: Some counterintuitive evidence from one low-income country

Ekman, Björn

doi:10.1016/j.healthpol.2007.02.004

Cited by 135 publications

(125 citation statements)

References 5 publications

(5 reference statements)

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…Evidence has also shown that health insurance could not protect the households against CHE and poverty in low-income countries. 24,25 This has also been confirmed by a study conducted in Iran.…”

Section: Discussionsupporting

confidence: 54%

The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran

Khammarnia

Keshtkaran

Kavosi

et al. 2015

Bangladesh Med Res Counc Bull

View full text Add to dashboard Cite

The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071±0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p<0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p<0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.

show abstract

Section: Discussionsupporting

confidence: 54%

The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran

Khammarnia

Keshtkaran

Kavosi

et al. 2015

Bangladesh Med Res Counc Bull

View full text Add to dashboard Cite

show abstract

“…Also, it was found that health insurance led to a fourfold decrease in incidence of CHE in Rwanda (22). However, health insurance did not help financial protection from the catastrophic spending on healthcare in Zambia (26). The overall protective effect of Health insurance seen in some other countries and places like Enugu State of Nigeria where the state civil servants have been included may not be evident in Oyo State if the breadth of the scheme is not extended.…”

Section: Discussionmentioning

confidence: 99%

National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

Ilesanmi

Adebiyi

Fatiregun

2014

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods: The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results: The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000-680,000 naira (46.7-4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1-118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3-16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion: Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.

show abstract

“…Catastrophic health expenditure is defined as out-of-pocket spending for health care that exceeds a certain proportion of a household's income with the consequence that households suffer the burden of disease. 1 A household is said to have been impoverished by medical expenses when health-care expenditure has caused it to drop below the poverty line. 2 In China, health insurance coverage has increased dramatically over the last decade, from 15% in 2000 to 96% in 2011.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance

Xu³

et al. 2012

Bull World Health Org

363

408

View full text Add to dashboard Cite

Catastrophic health payments and health insurance: Some counterintuitive evidence from one low-income country

Cited by 135 publications

References 5 publications

The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran

The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran

National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance

Contact Info

Product

Resources

About