Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment

Abstract

Background: Out-of-pocket (OOP) payments are configured as an important source of financing long-term care (LTC). However, very few studies have analyzed the risk of impoverishment and catastrophic effects of OOP in LTC. To estimate the contribution of users to the financing of LTC and to analyze the economic consequences for households in terms of impoverishment and catastrophism after financial crisis in Spain. Methods: The database that was used is the 2008 Spanish Disability and Dependency Survey, projected to 2012. We analyze the OOP payments effect associated to the impoverishment of households comparing volume and financial situation before and after OOP payment. At the same time, the extent to which OOP payment had led to catastrophism was analyzed using different thresholds. Results: The results show that contribution of dependent people to the financing of the services they receive exceeds by 50% the costs of these services. This expenditure entails an increase in the number of households that live below the poverty. In terms of catastrophism, more than 80% of households dedicate more than 10% of their income to dependency OOP payments. In annual terms, the catastrophe gap generated by devoting more than 10% of the household income to dependent care OOP payment reached €3955, 1 million (0.38% of GDP). Conclusion: This article informs about consequences of OOP in LCT and supplements previous research that focus on health. Our results should serve to develop strategic for protection against the financial risk resulting from facing the costs of a situation of dependence.

The economic burden incurred by families caring for a young child with developmental disability in Uganda

“…Earlier reviews have confirmed that parents caring a child with CP incur a larger socio-economic burden relating to that care than those whose children are not affected [ 21 , 23 ]. An understanding of the size and magnitude of this economic burden, most frequently mothers, can be contextualized by looking at the costs of caring in relation to the national income [ 36 ]. Households caring for children with developmental disabilities generally spend an annual average of between USD 981 and USD 2,508 more than the national average [ 39 ].…”

“…Rent/housing was excluded since homeowners do not pay rent meaning inclusion would negatively skew estimates of annual expenditure. We adopted the methodology used in previous studies on affordability and catastrophic expenditure for persons with disabilities, where expenditure on health is compared to household expenditure and determined to be catastrophic or unaffordable if it is more than 10-49% of household expenditure [33][34][35][36].…”

The Effect of the “Triple-Layer Medical Security” Policy on the Vulnerability as Expected Poverty of Rural Households: Evidence from Yunnan Province, China

“…Many analyses show that poor people are more susceptible to medical and health expenditure, and the lower the income, the more exposed to disease risks [88,89]. The greater the burden of medical expenditure on the family, the more likely it is to fall into poverty [90]. When health is affected, the heightened medical burden will squeeze non-medical consumption, affecting the financial ability of poor families.…”

Health Care Utilization and Out-of-Pocket Payments among Elderly with Cognitive Frailty in Malaysia

“…Likewise, the elderly with lower income levels spend less on health care services and are expected to gain less health compared to others. Additionally, health-related expenditures are important causes of financial catastrophes to patients and families [ 72 , 73 ]. It is worth mentioning that age is considered a significant influencing factor for higher health care related OOP payments [ 74 , 75 ].…”