Relationship Between Catastrophic Health Expenditures and Income Quintile Decline

Kang, Jeong-Hee; Kim, Chul-Woung

doi:10.24171/j.phrp.2018.9.2.06

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…Moreover, households that use public transportation always pay more than their counterparts, which proportionally increases the risk of incurring catastrophic medical costs. This study’s results are closely related to a case study conducted in the Republic of Korea, which demonstrates that despite the National Health Insurance system, a social insurance program that reduces the burden of OOP medical expenses, the amount of OOP expenses that individuals and their families are responsible for is still substantial, averaging 35.2% [ 41 ].…”

Section: Discussionsupporting

confidence: 65%

Laos’ Social Health Insurance (SHI) program’s impact on older people’s accessibility and financial security against catastrophic health expense

Bodhisane,

Pongpanich

2023

BMC Health Serv Res

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Laos has introduced various SHI schemes for multiple groups of the population, such as government officials and other population groups under the NHI schemes. There is no specific health insurance policy for this group of people who need special health services and may have a higher possibility of entering financial catastrophe. This study aims to assess the impact of SHI schemes on accessibility and financial catastrophe against catastrophic health expenditures for older people in Laos. A structured questionnaire has been used to retrieve information from 400 older people across 39 villages in Kaysone Phomvihane District, Savannakhet province, the largest province in Laos. In the analytical process, this study used a cross-sectional study design and binary logistic regression models to predict the likelihood of accessing health facilities and experiencing financial catastrophe. The study outcome shows that the increase in age, occupation, number of older people within a household, and presence of chronic conditions increase the likelihood of using health services. Despite the existence of various SHI schemes, this study found that 74 out of 165 households reported using health services experienced catastrophic health expenditure. Several characteristics are associated with catastrophic health expenditure: age, income level, and gender are prone to suffer from catastrophic health expenditure. The difficult problems stem from the absence of comprehensive legislation regarding the older population. Recommendations for policymakers in various timeframes have been made, which cover short- and long-term policy proposals, including providing a specialized lane or fast-track for an older population, building health facilities exclusively for older people, and providing transportation services for older individuals living alone.

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Section: Discussionsupporting

confidence: 65%

Laos’ Social Health Insurance (SHI) program’s impact on older people’s accessibility and financial security against catastrophic health expense

Bodhisane,

Pongpanich

2023

BMC Health Serv Res

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“…To which participants could answer: Completely; Moderately; A Little; Not at All [ 30 – 32 ]. The survey also collected information on income status which was used to rank the participants into quintiles: Q1 (lowest income quintile) to Q5 (highest income quintile) [ 33 – 36 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries: a cross sectional analysis of WHO-SAGE survey

2020

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In developing countries, older adults (65 years of age and above) share an increased vulnerability to catastrophic health expenditures and financial stress which can have significant bearing on their health and well-being. Currently, research evidence on how financial stress correlates with health and well-being among older adults in the developing countries is limited. Therefore, in this study, we aimed to assess the relationship between financial stress and subjective 1) health, 2) depression, 3) quality of life, and 4) life satisfaction among older adults in five developing countries. Methods Data used in this study were cross-sectional which were collected from the first wave of Study on Global AGEing and Health (SAGE) survey of World Health Organization. Sample population were 12,299 community dwelling men and women in China ( n = 4548), Ghana ( n = 1968), India ( n = 2441), South Africa ( n = 1924), and Russia ( n = 1418). Using generalized linear models with logit links, we assessed the correlation between self-reported financial stress and income inequality with the four outcome measures by adjusting for various sociodemographic factors. Results Overall, the prevalence of good self-reported health, quality of life and positive life-satisfaction was 47.11, 79.25 and 44.40% respectively, while 20.13% of the participants reported having depression during past 12 months. Only about a fifth (18.67%) of the participants reported having enough money to meet daily their necessities completely, while more than quarter (28.45%) were in the lowest income quintile. With a few exceptions, the odds of reporting good self-reported health, quality of life, and life satisfaction were generally lower among those with varying degrees of financial stress, and larger among those in the higher income quintiles. Conversely, the likelihood of self-reported depression was significantly higher among those with any level of financial stress, and lower among those in the higher income quintiles. Conclusion This study concludes that both subjectively and objectively measured financial stress are inversely associated with good self-reported health, quality of life, life satisfaction, and positively associated with self-reported depression among older adults.

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“…Our finding is consistent with Kang et al in Korea and Liu et al in China. 28,32 Although the study was designed with a large sample size covering most of the ethnic groups in Sarawak still, most of the ethnic groups in the study were from rural areas, and the urban and Chinese populations were under-reported. Thus, the results might have limited generalisability.…”

Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditure: a community-based study in Sarawak, Malaysia

Pangkas

Rahman

Suhaili

2021

Int J Community Med Public Health

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Background: Accessing health services can lead to individuals having to pay catastrophic proportions of their available income and push many households into poverty. The aim of the study was to estimate the catastrophic health expenditure in respect of household expenditure and to determine the factors affecting it in Sarawak, Malaysia.Methods: We collected household expenses based on a recall period of one month through a face-to-face interview. We calculated the catastrophic health expenditure in terms of 10% of household expenditure and 40% of the capacity to pay. A binary logistic regression analysis was done to determine the factors associated with catastrophic health expenditure. Data analysis was done by IBM SPSS version 27.0. Results: The analysis revealed that one-quarter (25.7%) of the household expenditure was on food, equivalent to MYR 373.562, and 18.83% of the total household expenditure was on health (MYR 292.83). About two-fifths (37.4%) of the households had incurred catastrophic health expenditure on 10% of household consumption and 15.6% catastrophic health expenditure on 40% of household expenditure. Multivariate analysis with forward and backward linear regression methods revealed that age, gender, family size, socioeconomic status, and chronic illness appeared to be potential predictors of 10% catastrophic health expenditure (p<0.05). In contrast, socioeconomic status and level of education appeared to be potential predictors for 40% catastrophic health expenditure (p<0.05).Conclusions: Subsidised health care may not protect against the occurrence of catastrophic health expenditure among the household in the lower socioeconomic status. Family size and age also could affect household catastrophic health expenditure.

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Relationship Between Catastrophic Health Expenditures and Income Quintile Decline

Cited by 13 publications

References 15 publications

Laos’ Social Health Insurance (SHI) program’s impact on older people’s accessibility and financial security against catastrophic health expense

Laos’ Social Health Insurance (SHI) program’s impact on older people’s accessibility and financial security against catastrophic health expense

Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries: a cross sectional analysis of WHO-SAGE survey

Catastrophic health expenditure: a community-based study in Sarawak, Malaysia

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