Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

Saksena, Priyanka; Hsu, Justine; Evans, David B.

doi:10.1371/journal.pmed.1001701

Cited by 192 publications

(225 citation statements)

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“…Often, the choice of the threshold is arbitrary but two commonly used ones are 10% of total income or 40% of non-food income (referred to as capacity to pay) [22]. To capture the burden on these households, a measure of the depth of poverty is needed [23].…”

Section: Catastrophic Spendingmentioning

confidence: 99%

Household Catastrophic Health Expenditure Due To Tuberculosis: Analysis From Particularly Vulnerable Tribal Group, Central India

Muniyandi¹,

Rao²

2016

Mycology

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Tuberculosis (TB) is disproportionately affects the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be catastrophic health expenditure for TB affected households in particularly vulnerable tribal groups (PVTGs). A survey of pulmonary tuberculosis (PTB) was carried out in Saharia dominated Pohri block of Shivpuri district of Madhya Pradesh state in central India during the period 2013 to 2014. Of 9964 surveyed, 280 PTB cases identified formed the study population for the present study. Among 280 TB patients identified, 220 (79%) cases interviewed at their residence by trained field investigators after obtaining written informed consent. This study demonstrates the economic burden in terms of direct, indirect and total costs for both diagnosis and treatment. In our sample, majority getting treatment free of costs and those who incurred costs, they faced catastrophic TB care expenditure amounted to 10%, which is the proportion of various costs in relation to annual family income. TB is a major cause of impoverishment, as it puts a heavy burden on the family budget, which can force families to absolute poverty. Our results suggest that policies to decrease direct and indirect TB patient costs are urgently needed to prevent chances of catastrophic payments to PVTGs. Also a high priority should be given to research that focuses on economic effects in different kind, in different time, in particular, among low-income groups.

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Section: Catastrophic Spendingmentioning

confidence: 99%

Household Catastrophic Health Expenditure Due To Tuberculosis: Analysis From Particularly Vulnerable Tribal Group, Central India

Muniyandi¹,

Rao²

2016

Mycology

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“…Worldwide, millions of people suffer from financial hardship due to out-of-pocket (OOP) health payments (1). As a result, the concept of financial risk protection remains a major focus of many health systems (2,3) and is a core component of universal health coverage (UHC) (1).…”

Section: Introductionmentioning

confidence: 99%

“…As a result, the concept of financial risk protection remains a major focus of many health systems (2,3) and is a core component of universal health coverage (UHC) (1). Financial protection is defined as access to needed and good quality health services without financial catastrophe.…”

Section: Introductionmentioning

confidence: 99%

“…Financial protection is defined as access to needed and good quality health services without financial catastrophe. One of the common indicators of financial protection is incidence of catastrophic expenditure due to health payments (1). OOP payment defines as catastrophic if it exceeds a certain threshold of the household consumption expenditure, the income, or the capacity to pay in a given period (4,5).…”

Section: Introductionmentioning

confidence: 99%

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Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

et al. 2017

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Background: Protecting people from catastrophic health payments is widely recognized as an integral component of health systems and universal health coverage. Objectives: This study aimed to measure the financial protection against catastrophic health expenditure among hospitalized patients in Kermanshah, western Iran, after the implementation of the health sector evolution plan of Iran. Methods: This was a cross-sectional study. A total of 544 patients were selected using the proportional allocation to population size technique. A translated version of the world health survey questionnaire was used to collect data. Catastrophic health expenditure was calculated using WHO recommended methodology. Data were analyzed using STATA v.13. The statistical test performed included descriptive statistics and logistic regression. Results: About 4.8% of households with hospitalized patients were faced with catastrophic health expenditures. The total mean outof-pocket (OOP) medical expenditures of being hospitalized was 819,220 Rials per patient. Mean OOP in patients with catastrophic payment was 2,220,500 Rial. Major determinants of catastrophic payment were associated with surgical cost (OR: 8.09 P Value = 0.000), chronic disease (OR: 2.78 P Value = 0.025), household size (> 6) (OR: 6.70 P Value < 0.036), and economic status of households (Quintile 5; OR: 0.005 P Value = 0.000). Conclusions:The Health Sector Evolution Plan should target and extend aids especially for chronically ill patients, those who need surgery, and those at poorest quintile due to the fact that they are more vulnerable to catastrophic health expenditure. These groups should be the priorities in the health sector evolution plan revision to achieve a more desired outcome.

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“…The literature confirmed that OOP for health care can cause a low-income household to feelimpoverished even though the official definition of poverty indicates that they are not poor (Saksena et al, 2014). The paper thereforeseeks to estimate the hidden (or underestimated) poverty due to not accounting health care cost while estimating the official poverty statistics in Nepal.…”

Section: Introductionmentioning

confidence: 92%

Effect of Payments for Disease Specific Care on Poverty Estimates in Nepal

Adhikari

2018

Econ J Dev Issues

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Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

Abstract: As part of a PLOS Collection on universal health coverage, Priyanka Saksena and colleagues examine existing measures of financial risk protection and suggest future developments that could be valuable in monitoring progress towards universal health coverage.

Cited by 192 publications

References 50 publications

Household Catastrophic Health Expenditure Due To Tuberculosis: Analysis From Particularly Vulnerable Tribal Group, Central India

Household Catastrophic Health Expenditure Due To Tuberculosis: Analysis From Particularly Vulnerable Tribal Group, Central India

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

Effect of Payments for Disease Specific Care on Poverty Estimates in Nepal

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