Out‐of‐pocket health expenditure and debt in poor households: evidence from Cambodia

Damme, Wim Van; Leemput, Luc Van; Ir, Por; Hardeman, W.; Meessen, Bruno

doi:10.1046/j.1365-3156.2003.01194.x

Cited by 210 publications

(190 citation statements)

References 21 publications

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“…After six months in Can Tho, more than two-thirds of those who borrowed had been unable to retire their debt; in Banteay Meanchey, this figure was 62%. Unlike the study in Cambodia, 10 we did not enquire about the terms of the loan or of interest rates but it is obvious that the impact of dengue infection was highest in those who were poor.…”

Section: Discussionmentioning

confidence: 93%

“…This change may result in unsettled debts and the selling of family land. 10 Our second objective was to ascertain whether there were any differences in knowledge and behavior of these 144 households with cases, in comparison to those without cases, to compare risk. To measure behavior outcomes, we hypothesized that case households would have greater numbers of immature and adult Aedes aegypti than those where dengue infection was not reported.…”

Section: Introductionmentioning

confidence: 99%

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High Household Economic Burden Caused by Hospitalization of Patients with Severe Dengue Fever Cases in Can Tho Province, Vietnam

Tam

Dat²,

Huu³

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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Abstract. During 2006-2007, a cohort of 144 confirmed dengue cases in Can Tho Province, Vietnam were compared with a matching set of 144 households that had no dengue cases. Approximately 6-9 months after sickness, there were no significant differences in terms of knowledge of the etiology of dengue, mosquito breeding habitats, and prevention measures in respondents from both sets of households. There was also no difference in the abundance of Aedes aegypti (Linn.) adults but the average numbers of late instar and pupal Ae. aegypti per household were greater in the negative control houses. Thus, the risk seemed to be no higher in case households, although it is conceivable that changes may have occurred in either group over the intervening period. The average cost for a dengue patient was 2,798,000 Vietnamese Dong (VND) (US$167.77), 2,154,000 VND for direct costs, and 644,000 VND for indirect costs. There was a 22% difference in cost for those with and without health insurance. In terms of impact on family economies, 47.2% had to borrow money for treatment, and after 6 months, 71.7% had not begun or had only managed part repayments. Approximately 72.9% indicated that the cost of supporting a dengue patient had impacted on the family economy, with the loss averaging 36% of the annual income in the lowest economic quartile.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

High Household Economic Burden Caused by Hospitalization of Patients with Severe Dengue Fever Cases in Can Tho Province, Vietnam

Tam

Dat²,

Huu³

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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“…It ignores variation in the capacity of households to draw on savings, assets, credit and transfers from friends and relatives to meet payments for health care and so protect consumption of other goods, at least in the short term. Evidence on how households in low-income countries finance health care is mostly from small-scale surveys (Sauerborn et al, 1996;Wilkes et al, 1998;Carter and Maluccio, 2003;Russell, 2004;van Damme, 2004). Notwithstanding their limited generalizability, these studies typically find that households finance a substantial share of health-care costs from coping strategies such as savings, credit, asset sales, etc.…”

Section: Introductionmentioning

confidence: 99%

Coping with health‐care costs: implications for the measurement of catastrophic expenditures and poverty

et al. 2008

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SUMMARYIn the absence of formal health insurance, we argue that the strategies households adopt to finance health care have important implications for the measurement and interpretation of how health payments impact on consumption and poverty. Given data on source of finance, we propose to (a) approximate the relative impact of health payments on current consumption with a 'coping'-adjusted health expenditure ratio, (b) uncover poverty that is 'hidden' because total household expenditure is inflated by financial coping strategies and (c) identify poverty that is 'transient' because necessary consumption is temporarily sacrificed to pay for health care. Measures that ignore coping strategies not only overstate the risk to current consumption and exaggerate the scale of catastrophic payments but also overlook the long-run burden of health payments. Nationally representative data from India reveal that coping strategies finance as much as three-quarters of the cost of inpatient care. Payments for inpatient care exceed 10% of total household expenditure for around 30% of hospitalized households but less than 4% sacrifice more than 10% of current consumption to accommodate this spending.Ignoring health payments leads to underestimate poverty by 7-8% points among hospitalized households; 80% of this adjustment is hidden poverty due to coping.

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“…st March 2001, the Government of Uganda abolished user charges in public health centers enabling the poor to receive medical care and improve their health seeking behavior (7,11). The abolition of user charges was aimed at achieving the Millennium Development Goals on a national, regional and international scale.…”

Section: Onmentioning

confidence: 99%

Impact of Shared Health Services on Service Quality at Health Centres in Kampala Capital City Authority (Kcca)

Madinah¹,

Boerhannoeddin²,

Noriza³

2017

JUMMEC

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The study aimed to assess whether sharing of health services improved service quality in health centers in Kampala Capital City Authority (KCCA). With multi-stage sampling, data was gathered by face to face interviews, via translators from residents in the five divisions of KCCA, using a questionnaire. Schedules were made with Local Council I chairmen, and support to fill in the questionnaire was given to the respondents. The statistical methods used for analysis included a Chi-square, Spearman correlations and hierarchical regression.The study found that regarding tangibility, sharing health services significantly determines the number of modern medical equipments (p=0.000) and the number of medical personnel that had a neat and professional appearance (p=0.000) but did not determine the number of visually appealing health facilities (p=0.386).Recentralizing health care changed the mode of delivery. Health workers were responsive, reliable and provide better care for patients. There was increased availability of basic medical equipment, and health workers were neater in appearance with increased confidence and hence were better able to provide for the safety of residents.

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Out‐of‐pocket health expenditure and debt in poor households: evidence from Cambodia

Cited by 210 publications

References 21 publications

High Household Economic Burden Caused by Hospitalization of Patients with Severe Dengue Fever Cases in Can Tho Province, Vietnam

High Household Economic Burden Caused by Hospitalization of Patients with Severe Dengue Fever Cases in Can Tho Province, Vietnam

Coping with health‐care costs: implications for the measurement of catastrophic expenditures and poverty

Impact of Shared Health Services on Service Quality at Health Centres in Kampala Capital City Authority (Kcca)

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