Catastrophic long-term care expenditure: associated socio-demographic and economic factors

Rubio, Raúl del Pozo; Salido, Román Mínguez; García, Isabel Pardo; Sotos, Francisco Escribano

doi:10.1007/s10198-019-01031-8

Cited by 19 publications

(21 citation statements)

References 32 publications

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“…36 Other studies from developed countries also reported a higher risk of CHE among the lowest income households than the highest income ones. 37 , 38 Unlike in our findings, the provinces located in northern, northeastern, and central parts of Iran were reported to have better access to healthcare services. 39 The reasons for this difference require further investigation.…”

Section: Discussioncontrasting

confidence: 99%

<p>Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation</p>

Kazemi-Karyani¹,

Woldemichael²,

Soofi³

et al. 2020

CEOR

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Objective Ensuring fair financial contribution is one of the main goals of the Health Transformation Plan (HTP) of Iran. This study aims to estimate socioeconomic inequality differences in catastrophic health expenditure (CHE) between urban and rural areas of Iran after the implementation of the HTP during 2017. Materials and Methods Data from a representative survey of households’ income and xpenditure from the Iran Statistical Center (ISC) were used for the analysis. We applied the World Health Organization (WHO) cut-off of 40% payment for CHE, and Wagstaff’s normalized concentration index ( C ) to measure and decompose the inequality. Also, Blinder–Oaxaca decomposition analysis was used to decompose contributors of inequality differences between rural and urban areas. Results The overall incidence of CHE among Iranian households during the year 2017 was 3.32% with a standard deviation (SD) of 17.91%, and the mean (SD) levels of CHE in rural and urban areas of Iran were 4.37% (20.45%) and 2.97% (16.99%), respectively. The aggregate socioeconomic status (SES)-related inequality in CHE was significantly ( p <0.001) different from zero ( C =−0.238) and there was a significant ( p <0.05) difference between rural ( C =-0.150) and urban ( C =0.218) areas. SES was the highest contributor to inequality in both rural (130.09) and urban (144.17) areas. The Blinder–Oaxaca decomposition revealed that SES (175.01%) followed by outpatient services (120.29%) were the main contributors to differences in inequality in rural and urban areas. Sex (−101.42%) and health insurance coverage were among negative contributors to this inequality difference. Conclusion Our findings revealed a significant pro-rich inequality in CHE. Also, some variables, such as sex and region, made different contributions in rural and urban areas. However, SES, itself, made the highest contribution in both areas and explained the greatest share of difference in inequality between the two areas. This issue calls for revision of the HTP to further address the risk of CHE and socioeconomic disparity among Iranian households, especially those with lowSES.

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Section: Discussioncontrasting

confidence: 99%

<p>Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation</p>

Kazemi-Karyani¹,

Woldemichael²,

Soofi³

et al. 2020

CEOR

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“…view than the earlier literature. Some study found that households living in a rural area, and female participants were highly prone to nancial risk due to higher out-of-pocket health payments [14,18,19].…”

Section: Discussionmentioning

confidence: 99%

Does Disability Increase Households’ Health Financial Risk: Evidence From The Uganda Demographic and Health Survey

Guets¹,

Behera²

2021

Preprint

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Background: In the last few years, there has been a worldwide commitment to protect the vulnerable individuals from higher financial risk through out-of-pocket (OOP) health expenditure and provide a platform for universal access to healthcare through a pre-payment insurance mechanism. In a developing country like Uganda, OOP spending represents a significant component of health expenditure. Financial risk protection strategy for the vulnerable is always a debatable issue in these economies. Therefore, this study examines the influence of disability and socio-demographic factors on households’ health financial risks in Uganda.Methods: We used cross-sectional, nationally representative data from the Uganda Demographic and Health Survey (UDHS) collected in 2016 by the Uganda Bureau of Statistics (UBOS) in Uganda. We measured Financial risk (households’ health expenditure) by money paid for health care services. We estimated the “probit” model to investigate the effect of disability on health financial risk.Results: A total of 19,305 households were included in this study. Almost 33% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority (73%) of families went to the public sector for health care services. The mean age was 45 years (SD±15). We find that disability significantly increases the probability of household financial risk (p < 0.01). The private sector’s choice for health care services is likely to increase the financial risk compared to the public sector (p < 0.01). The wealthier the household was, the more money paid for health service was (p < 0.01).Conclusion: Our results indicated that disability and household socio-demographic characteristics were associated with health financial risk in Uganda. Identifying families with disability and experiencing difficult living conditions constitute an entry point for health authorities to enhance health coverage progress in low – middle-income countries.JEL Classification: J14; I14; J1; I32; J71; C83

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“…Excessively high out-of-pocket medical payment can lead to catastrophic expenditure [4,21,22]. Even for countries with tax-based universal health insurance systems, we do not have sufficient evidence to show the impact of economic recession on health care payments [23][24][25][26][27].…”

Section: Literature Reviewmentioning

confidence: 99%

Will the Economic Recession Inhibit the Out-of-Pocket Payment Willingness for Health Care?

Zheng

Huang

Jiang

2020

IJERPH

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We used an individual regression and panel data regression method to analyze the samples of 60 countries from 2000 to 2016 to study the impact of the economic recession on residents’ out-of-pocket payment willingness for health care. Although we found an increase in the willingness during the economic recession in most countries, we couldn’t find significant evidence of a positive relationship between the economic recession and such willingness. We discovered that the relationship differentiates in different countries, which mainly depends on the differences in the medical systems and degree of economic development. By controlling individual differences in countries, we found that the economic recession inhibited the out-of-pocket payment willingness for health care. Especially after the impact of the financial crisis in 2008, the cumulative effect of the economic recession and the aftershock of financial crisis was discovered, which significantly inhibited residents’ willingness. In addition, we verified that the economic recession inhibited the out-of-pocket payment willingness by reducing employee compensation in specific types of countries.

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Catastrophic long-term care expenditure: associated socio-demographic and economic factors

Cited by 19 publications

References 32 publications

<p>Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation</p>

<p>Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation</p>

Does Disability Increase Households’ Health Financial Risk: Evidence From The Uganda Demographic and Health Survey

Will the Economic Recession Inhibit the Out-of-Pocket Payment Willingness for Health Care?

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