Catastrophic Healthcare Payments and Impoverishment in the Occupied Palestinian Territory

Mataria, Awad; Raad, Firas; Abu‐Zaineh, Mohammad; Donaldson, Cam

doi:10.2165/11318200-000000000-00000

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…Due to a lack of consensus in domestic and international literature concerning the best methodology for calculating such expenditure, three different forms of calculations, widespread in literature, were employed: methodology proposed by Xu et al 21 (2003), used by Wagstaff & Van Doorslaer 19 (2003), and a variation of the Wagstaff & Van Doorslaer methodology. 7 , 12 Thus, a more deep understanding of the phenomenon in the country is possible as well as better comparison of results with findings from other countries.…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic inequality in catastrophic health expenditure in Brazil

et al. 2014

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OBJECTIVE To analyze the evolution of catastrophic health expenditure and the inequalities in such expenses, according to the socioeconomic characteristics of Brazilian families.METHODS Data from the National Household Budget 2002-2003 (48,470 households) and 2008-2009 (55,970 households) were analyzed. Catastrophic health expenditure was defined as excess expenditure, considering different methods of calculation: 10.0% and 20.0% of total consumption and 40.0% of the family’s capacity to pay. The National Economic Indicator and schooling were considered as socioeconomic characteristics. Inequality measures utilized were the relative difference between rates, the rates ratio, and concentration index.RESULTS The catastrophic health expenditure varied between 0.7% and 21.0%, depending on the calculation method. The lowest prevalences were noted in relation to the capacity to pay, while the highest, in relation to total consumption. The prevalence of catastrophic health expenditure increased by 25.0% from 2002-2003 to 2008-2009 when the cutoff point of 20.0% relating to the total consumption was considered and by 100% when 40.0% or more of the capacity to pay was applied as the cut-off point. Socioeconomic inequalities in the catastrophic health expenditure in Brazil between 2002-2003 and 2008-2009 increased significantly, becoming 5.20 times higher among the poorest and 4.17 times higher among the least educated.CONCLUSIONS There was an increase in catastrophic health expenditure among Brazilian families, principally among the poorest and those headed by the least-educated individuals, contributing to an increase in social inequality.

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Section: Methodsmentioning

confidence: 99%

Socioeconomic inequality in catastrophic health expenditure in Brazil

et al. 2014

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“…Leive and Xu (2008) [14] examined how households in 15 African countries characterized by low government health spending and lack of health insurance, cope with health shocks. 5 In 12 countries, high inpatient spending increased the likelihood of borrowing or selling assets. They also found that the high-income quintiles were less likely to use coping strategies relative to the poorest households.…”

Section: Literature Reviewmentioning

confidence: 99%

“…They also found that lower-income and rural households face greater financial risk. In another study, Mataria et al (2010) [5] examined the incidence and intensity of catastrophic and impoverishing healthcare payments borne by Palestinian households between 1998 and 2007. They found a low incidence of catastrophic health payments with only 1% of the surveyed households spent more than 40% of their total household expenditures (net of food expenses) on healthcare in 1998; however, the percentage was almost doubled in 2007.…”

Section: Literature Reviewmentioning

confidence: 99%

“…These institutions are financially independent organizations under the authority of the Ministry of Health. The private sector includes for-profit hospitals, clinics, and pharmacies while the civil society consists of 5 The 15 African countries are Burkina Faso, Chad, the Congo, Cote d'Ivoire, Ethiopia, Ghana, Kenya, Malawi, Mali, Mauritania, Namibia, Senegal, Swaziland, Zambia and Zimbabwe.…”

Section: Literature Reviewmentioning

confidence: 99%

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Catastrophic Economic Consequences of Healthcare Payments: Effects on Poverty Estimates in Egypt, Jordan, and Palestine

Rashad¹,

Sharaf²

2015

Economies

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Healthcare payments could drive households with no health insurance coverage into financial catastrophe, which might lead them to cut spending on necessities, sell assets, or use credit. In extreme cases, healthcare payments could have devastating consequences on the household economic status that would push them into extreme poverty. Using nationally representative surveys from three Arab countries, namely, Egypt, Jordan, and Palestine, this paper examines the incidence, intensity and distribution of catastrophic health payments, and assesses the poverty impact of out-of-pocket health payments (OOP). The OOP for healthcare were considered catastrophic if it exceeded 10% of a household's total expenditure or 40% of non-food expenditure. The poverty impact was evaluated using poverty head counts and poverty gaps before and after OOP. Results show that OOP exacerbate households' living severely in Egypt, pushing more than one-fifth of the population into a financial catastrophe and 3% into extreme poverty in 2011. However, in Jordan and Palestine, the disruptive impact of OOP remains modest over time. In the three countries, the catastrophic health payment is the problem of the better off households. Poverty alleviation policies should help reduce the reliance on OOP to finance healthcare. Moving toward universal health coverage could also be a promising option to protect households from the catastrophic economic consequences of health care payments.

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“…28 Although budget share (share of healthcare payments from total income/consumption) is used extensively in the current studies, there is no consensus on the threshold of catastrophic payments in the literature. The current studies 11,16,17,25,[29][30][31][32] have used the threshold between 3% of budget share to 40% of the capacity to pay (ie, income/consumption minus subsistence expenditure requirements). Similar to the threshold ranges used in the Statistics Canada's report, 33 we used 3 and 6% of household consumption as the cut-off.…”

Section: Ethical Issuesmentioning

confidence: 99%

Universal Pharmacare in Canada: A Prescription for Equity in Healthcare

Hajizadeh

Edmonds

2019

Int J Health Policy Manag

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Despite progressive universal drug coverage and pharmaceutical policies found in other countries, Canada remains the only developed nation with a publicly funded healthcare system that does not include universal coverage for prescription drugs. In the absence of a national pharmacare plan, a province may choose to cover a specific sub-population for certain drugs. Although different provinces have individually attempted to extend coverage to certain subpopulations within their jurisdictions, out-of-pocket expenses on drugs and pharmaceutical products (OPEDP) accounts for a large proportion of out-of-pocket health expenses (OPHE) that are catastrophic in nature. Pharmaceutical drug coverage is a major source of public scrutiny among politicians and policy-makers in Canada. In this editorial, we focus on social inequalities in the burden of OPEDP in Canada. Prescription drugs are inconsistently covered under patchworks of public insurance coverage, and this inconsistency represents a major source of inequity of healthcare financing. Residents of certain provinces, rural households and Canadians from poorer households are more likely to be affected by this inequity and suffer disproportionately higher proportions of catastrophic out-of-pocket expenses on drugs and pharmaceutical products (COPEDP). Universal pharmacare would reduce COPEDP and promote a more equitable healthcare system in Canada.

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Catastrophic Healthcare Payments and Impoverishment in the Occupied Palestinian Territory

Cited by 22 publications

References 21 publications

Socioeconomic inequality in catastrophic health expenditure in Brazil

Socioeconomic inequality in catastrophic health expenditure in Brazil

Catastrophic Economic Consequences of Healthcare Payments: Effects on Poverty Estimates in Egypt, Jordan, and Palestine

Universal Pharmacare in Canada: A Prescription for Equity in Healthcare

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