Variations in catastrophic health expenditure estimates from household surveys in India

Raban, Magdalena Z.; Dandona, Rakhi; Dandona, Lalit

doi:10.2471/blt.12.113100

Cited by 85 publications

(84 citation statements)

References 19 publications

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“…Third, our expenditure estimates were derived from 14 items with a recall frame of 4 weeks. It has been previously shown that estimates of health expenditure are affected by the methodology used to collect data [37–39]. However, the WHS expenditure data had good test-retest reliability [30].…”

Section: Discussionmentioning

confidence: 99%

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

2017

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BackgroundDental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services.MethodsWe used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates.ResultsHouseholds that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52–1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services.ConclusionHouseholds with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.

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Section: Discussionmentioning

confidence: 99%

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

2017

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“…Third, our CDHE estimates were based on two questions and a 12-month recall period. There is evidence that estimates of heath spending are lower when using fewer health expenditure questions and longer recall periods [36–38]. As the survey did not include questions on total household expenditure, we used household income, as a proxy, in the denominator to estimate CDHE, which may not be responsive to the means of financing health care (savings, loans, selling assets, income transfers, etc.)…”

Section: Discussionmentioning

confidence: 99%

Determinants of Catastrophic Dental Health Expenditure in China

et al. 2016

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This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households’ finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services.

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“…Some studies have used a wide range of threshold criteria, ranging from 5 to 40 % of the household capacity, as the threshold value for defining CHE (Raban et al 2013;Van Minh et al 2013;Wagstaff and Van Doorslaer 2003;Xu et al 2003;Yardim et al 2010;Zhang et al 2010). The most commonly adopted thresholds were in a range from 10 to 40 % in the Korean studies (Kim and Yang 2009;Lee and Shin 2005;Shin et al 2010;Sohn et al 2010;Song and Shin 2010).…”

Section: Catastrophic Health Expenditurementioning

confidence: 96%

Catastrophic Health Expenditures and Life Satisfaction: A Case in South Korea

Kim

Hong

2015

J Fam Econ Iss

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This study examined the prevalence of households in South Korea that had experienced catastrophic health expenditures (CHE) and the impact of such expenditures on life satisfaction. Using data from the 2010 Korean Longitudinal Study of Ageing, this study found that the poverty-national health insurance (NHI) group had the highest likelihood of having CHE but the effect on life satisfaction of having CHE varied among the household groups, mainly in terms of income level and type of medical benefit programs. Households in the poverty-NHI group exhibited much lower satisfaction compared to other groups when they experienced CHE. This study further showed that the harmful effect of facing CHE was confined not only to poor health outcomes or economic hardships but also extended to generally lower life satisfaction in the poverty-NHI group. These findings underscore the importance of providing an adequate financial safety net for the health care of households in the poverty-NHI group.

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Variations in catastrophic health expenditure estimates from household surveys in India

Cited by 85 publications

References 19 publications

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

Determinants of Catastrophic Dental Health Expenditure in China

Catastrophic Health Expenditures and Life Satisfaction: A Case in South Korea

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