Magnitude and determinants of inpatient health expenditure among the elderly in India

2021 ◽  
Author(s):  
Chandrima Chatterjee ◽  
Narayan Chandra Nayak ◽  
Jitendra Mahakud
Keyword(s):  
Health Expenditure ◽  
The Elderly

scholarly journals Out-Of-Pocket Health Expenditure Among the Elderly in Kenya

2020 ◽  
Vol 12 (11) ◽  
pp. 53
Author(s):  
Emmanuel Mulaa Opondo ◽  
Martine Odhiambo Oleche
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Expenditure ◽  
The Elderly ◽  
Chronic Illnesses ◽  
Elderly Persons ◽  
Health Coverage ◽  
Financial Risk Protection ◽  
Insurance Cover ◽  
Concentration Curves

Financial risk protection against the burden of out-of-pocket health expenditure (OOPHE) by achieving universal health coverage (UHC) is a key health priority for developing countries. The elderly is a vulnerable demographic group that need this protection. This study sought to analyze how selected social and demographic factors affect OOPHE among the elderly in Kenya. Further, it aimed to determine the distribution of OOPHE among the various wealth quintiles in the elderly using a cross-sectional study. Data was sourced from the Kenya Household Health Expenditure and Utilization Survey (KHHEUS) 2013. The sample size (2,853) consisted of individuals ≥ 60 years who had utilized health services. A multiple regression model and concentration curves were applied. Increasing age, having chronic illnesses, male gender, higher education level, more wealth, possessing health insurance, increased distance, and a higher number of visits to the health facility positively affected OOPHE. These results were statistically significant (P < .050) for presence of chronic illnesses, increasing age, possessing a health insurance cover and being in the richest wealth quintile and insignificant for the rest. Moreover, concentration curves revealed that out-of-pocket (OOP) health payments were concentrated in the richest quintile individuals. Consequently, OOPHE is a regressive way of funding health care among the elderly. In conclusion, elderly persons need financial protection when seeking health care: achievable mainly through health reforms, especially the ones targeting health insurance.

scholarly journals Main Driving Factors and Prediction Model of Total Health Expenditure in China: A Study Based on Grey System Theory

2019 ◽  
Author(s):  
Huanhuan Jia ◽  
Xihe Yu ◽  
Jianxing Yu ◽  
Zhou Zheng ◽  
Yingying Li ◽  
...  
Keyword(s):  
System Theory ◽  
Prediction Model ◽  
Health Expenditure ◽  
The Elderly ◽  
Grey System Theory ◽  
Driving Factors ◽  
System Reform ◽  
Total Health Expenditure ◽  
Grey System ◽  
Correlation Degree

Abstract Background: The continuous increase in total health expenditure has become a social issue of common concern in most countries. In China, the total health expenditure still maintains a fast growth trend which is much higher than the growth of the country’s economy, although the new health system reform had been going on for 8 years until 2017. The aims of the current study were thus to investigate the main driving factors affecting total health expenditure and to establish a prediction model. Methods: Gray system theory was employed to explore the correlation degree between total health expenditure and 13 hot spots from the fields of economy, population, health service utilization, and public policy using national data in China from 2009 to 2017. Besides, a prediction model was established using the main driving factors among the 13 hot spots. Results: The main driving factors related to the changes of total health expenditure were public policy (ranked first), health development, economics, and aging, which correlation degrees were more than 0.7. The average error of the GM(1,7) model was 3.17%, the correlation degree, β , between the predicted simulation sequence and the original sequence was 0.78, the variance ratio, C, was 0.138, and the probability of residuals, P, was 1.0000. Therefore, the prediction model of total health expenditure with 6 main driving factors was excellent. Conclusion: The paper finds that since the new health system reform in China, government policies and social invest have contributed greatly to reducing the burden of health expenditure. However, the development of economic and the increase in the elderly population, which are main driving factors, will increase the total health expenditure, so improving the efficiency of investment and providing the precautionary health care and nursing for the elderly are crucial. Besides, the grey system theory had a good application in the field of health economics and policy.

scholarly journals Investing preventive care and economic development in ageing societies: empirical evidences from OECD countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fuhmei Wang ◽  
Jung-Der Wang
Keyword(s):  
Economic Growth ◽  
Health Expenditure ◽  
Functional Disability ◽  
The Elderly ◽  
Oecd Countries ◽  
Sustainable Growth ◽  
Prevalence Rates ◽  
Ageing Society ◽  
Medical Resources ◽  
Effective Prevention

Abstract Background The proportion of the elderly aged 65 years old or above will reach 16% in 2050 worldwide. Early investment in effective prevention would generally reduce the morbidity, complication, functional disability, and mortality of most chronic illnesses and save resources in both healthcare and social services. This research aims to investigate how the optimal allocation of medical resources between prevention and treatment adds value to the population’s health as well as examine the interaction between ageing, health, and economic performance. Methods This research undertakes ageing-health analyses by developing an economic growth model. Based on the Organization for Economic Co-Operation and Development (OECD) countries’ experiences over the period from 2000 to 2017, this research further examines the hypothesis that an ageing society could increase demand for preventive and curative healthcare. Results Theoretical analysis found that the prevention share for maximizing growth is the same as that for minimizing ill health and maximizing welfare; this share increases with treatment share and ageing ratios. Estimation results from OECD countries’ experiences indicate that when treatment share increases by 1%, the prevention demand increases by 0.036%. A one-percent increase in the ageing ratio yields a change in prevention share of 0.0368%. The optimal share of prevention health expenditure to GDP would be 1.175% when the prevalence rate of ill health isat 6.13%; a higher or lower share of prevention would be accompanied with a higher prevalence of ill health. For example, a zero and 1.358% preventive health expenditure would be associated with an 18.01% prevalence of ill health, while the current share of prevention of 0.237% is associated with a 10.26% prevalence of ill health. Conclusion This study shows that appropriate prevention is associated with decreases in the prevalence rates of ill health, which in turn attains sustainable growth in productivity. Too much prevention, however, could lead to higher detection of new chronic diseases with mild severity, which would result in longer illness duration, and higher prevalence rates of ill health. With suitable allocation of medical resources, the economic growth rate will help to cancel out increases in healthcare spending for the elderly and for expenses needed for the improvement of the population’s health as a whole.

scholarly journals The Indirect Cost of Disability Adjusted Life Years Lost among the Elderly in Kenya

10.3823/2483 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Joses Muthuri Kirigia ◽  
Gitonga N Mburugu ◽  
Guyo Sarr Huka
Keyword(s):  
Indirect Cost ◽  
Health Expenditure ◽  
The Elderly ◽  
Health Condition ◽  
Disability Adjusted Life Years ◽  
Total Health Expenditure ◽  
Productivity Losses ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Per Capita

Background: As Kenya accelerates the momentum to attain the Sustainable Development Goals (SDG) 3 on health and 13 on combatting impacts of climate change, it is critically important not to overlook their impacts on the elderly, i.e. people aged 60 years and above (elderly). The objective of this study was to estimate the indirect cost (productivity losses) of disability-adjusted life years (DALYs) lost among the elderly in Kenya in 2015.Methods: The indirect cost associated with jth disease (or health condition) DALYs lost among the elderly is the product of the per capita non-health GDP in purchasing power parity (PPP) and the total jth disease (or health condition) DALYs lost in a specific age group. Per capita non-health GDP equals Kenya’s per capita GDP minus total health expenditure in 2015. The study covers all the diseases and health conditions reported in WHO Global Health Observatory (GHO). The data on DALYs and per capita total health expenditure were obtained from WHO GHO; while per capita GDP data was from IMF World Economic Outlook database.Results: About 2,238,004 DALYs were lost among the elderly in 2015. That health loss resulted into a total indirect cost of Int$ 7,088,274,986; which was evenly distributed among males and females. Approximately, 64.1% of the indirect cost resulted from non-communicable diseases, 29.3% from communicable and nutritional conditions, and 12.2% from injuries. If Kenya is able to fully achieve SDG targets 3.1 on maternal mortality, 3.3 on communicable diseases, 3.4 on NCDs and 3.6 on road traffic accidents by 2030, that would lead to a reduction of 625,238.21 DALYs (38.4%) lost among the elderly, which is equivalent to a saving of Int$ 1,986,641,742 (44.9%) in indirect costs (productivity losses).Conclusions: Kenya incurs every year substantive productivity losses due to morbidity and premature mortality among the elderly. Therefore, there is need for increased government, private sector and partner investments into health and wellbeing of the elderly to prolong their intrinsic and functional capacities.Key words: Elderly, indirect cost, productivity loss, disability-adjusted life year (DALY)

scholarly journals Catastrophic Health Expenditure Incidence and Its Equity in China: A Study on the Initial Implementation of the Medical Insurance Integration System

2019 ◽  
Author(s):  
huan liu ◽  
hong zhu ◽  
jiahui wang ◽  
xinye qi ◽  
miaomiao zhao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Health Expenditure ◽  
Concentration Index ◽  
Medical Insurance ◽  
The Elderly ◽  
Catastrophic Health Expenditure ◽  
Primary Data ◽  
Integration System ◽  
The Impact

Abstract Introduction: By 2013, several regions in China have introduced health insurance integration policies. However, few studies have addressed the impact of medical insurance integration in China. This study investigates catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated areas and non-integrated areas in China in 2013. Methods: The primary data are drawn from the fifth China National Health Services Survey in 2013. The final sample comprises 19,788 households (38.4%) from integrated areas and 31,797 households (61.6%) from non-integrated areas. A probit model is employed to decompose the inequality of the incidence of catastrophic health expenditure in line with the methodology used for decomposing the concentration index. Results: The incidence of catastrophic health expenditure in integrated areas is higher than in non-integrated areas (13.87% vs. 13.68%, respectively). The concentration index in integrated areas and non-integrated areas is -0.071 and -0.073, respectively. Average household out-of-pocket health expenditure and average capacity to pay in integrated areas are higher than in non-integrated areas. However, households in integrated areas have lower out-of-pocket expenditures share in capacity to pay than households in non-integrated areas. The majority of the observed inequalities in catastrophic health expenditure can be explained by differences in the health insurance and householders’ educational attainment both in integrated areas and non-integrated areas. However, compared with non-integrated areas, the inequity caused by integrated medical insurance has been significantly reduced in integrated areas. Conclusions: The medical insurance integration system in China is still at the exploring stage; hence, its effects are of limited significance. Regardless of the area, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and the use of health services significantly affect the equity of catastrophic health expenditure incidence. Keywords: Catastrophic health expenditure, Medical insurance integration system, Equity, Influencing factors

scholarly journals Effect of Aging on Health Expenditure and Gross Domestic Product in Selected Countries by A Dynamic Panel Approach

2019 ◽  
Author(s):  
Jafar Yahyavi Dizaj ◽  
Faroogh Na'emani ◽  
Yousef Mohammadzadeh ◽  
Kamran Irandoust
Keyword(s):  
Gross Domestic Product ◽  
Method Of Moments ◽  
Health Expenditure ◽  
Negative Impact ◽  
Generalized Method Of Moments ◽  
The Elderly ◽  
Dynamic Panel Data ◽  
Economic Effects ◽  
Domestic Product ◽  
Dynamic Panel

Background: An increase in the aging population can affect economic growth and Gross Domestic Product (GDP) by reducing labor supply, reducing productivity, and increasing burden on the population. The current study aimed to explain the economic effects of aging and examined the relationship between aging, health expenditure, and GDP.   Methods: This descriptive-analytical study was conducted using the data of global development indicators, published by World Bank for the selected countries from 1996 to 2017. The study population included 40 selected countries with moderate to high income. The data related to each country were extracted. Later, the dynamic panel data approach and generalized method of moments (GMM) were applied to analyze the information. Furthermore, the generalized method of moments regression was also used by Stata 14. Results: The findings showed that aging had a negative and significant effect on GDP, so that increase of 1.00 % in the elderly population decreased the GDP growth by 2.14 %. Furthermore, countries' investment in the health sector had a positive and significant effect on the GDP. In this regard, an increase of 1.00 % in health and treatment costs improved the GPD by 0.03 %. Multiplication of  aging in health expenditure and inflation index had a significant negative impact on the growth of GDP per capita. Conclusion: The results of this study showed that population aging reduced GDP by absorbing a part of the health expenditure. Therefore, in order to reduce the negative effects of this phenomenon, a long-term approach to budgeting is required to strengthen and support the pension fund, plan more comprehensive health insurance coverage for the elderly, and develop related institutions.

scholarly journals Impact of the Elderly on Household Health Expenditure in Bihar and Kerala, India

2018 ◽  
Vol 20 (1) ◽  
pp. 1-14 ◽  
Author(s):  
David Loutfi ◽  
Jean-Frédéric Lévesque ◽  
Subrata Mukherjee
Keyword(s):  
Chronic Disease ◽  
Health Expenditure ◽  
Insurance Coverage ◽  
The Elderly ◽  
National Sample ◽  
Catastrophic Health Expenditure ◽  
Sample Survey ◽  
Ageing Population ◽  
Indian States ◽  
The Impact

Ageing in India is leading to an increase in chronic diseases. Given the limited health insurance coverage, this could lead to a variety of economic- and access-related consequences for the households. Against this backdrop, this article aims at examining the impact of the presence of the elderly on household health expenditure, avoidance of treatment, loss of income and use of alternate sources of funding to pay for care. The article uses data from 2004 National Sample Survey Organisation survey on healthcare for two Indian states, namely, Bihar and Kerala. The rate of catastrophic health expenditure (CHE) is found to be higher in Kerala and is associated with a higher proportion of households having elderly members, who, in turn, have higher incidence of chronic disease. While the presence of elderly in the household, incidence of chronic disease and treatment from private sources are linked to CHE, our results suggest that other groups, such as households without elderly, may simply be delaying the economic consequences of paying for healthcare by borrowing. Though the ageing population is leading to increased health expenditure for households due to increased chronic illness, the impact of using private treatment is much less clear.

scholarly journals Measurement and determinants of catastrophic health expenditure among the elderly households in China using longitudinal data from the CHARLS

2020 ◽  
Author(s):  
Shiai Liu ◽  
Peter Christopher Coyte ◽  
Mingqi Fu ◽  
Qilin Zhang
Keyword(s):  
Logistic Regression ◽  
Health Expenditure ◽  
The Elderly ◽  
Chronic Health Condition ◽  
Catastrophic Health Expenditure ◽  
Health Condition ◽  
Gradual Improvement ◽  
Food Expenditure ◽  
Key Policy ◽  
Elderly Households

Abstract Background: Catastrophic health expenditure (CHE) among the Chinese elderly warrants attention. However, the incidence, intensity and determinants of CHE have not been fully investigated. This study explores the incidence, intensity and determinants of CHE among elderly Chinese citizens, i.e., those aged 60 years or older.Methods: Data were obtained from three waves of the China Health and Retirement Longitudinal Study (CHARLS): 2011, 2013 and 2015. The cut-off points used in this study for CHE were 10% of the total expenditures and 40% of non-food expenditure. Under the guidance of Andersen’s model of health services utilization, this study used logistic regression analysis to explore the determinants of CHE.Results: The incidence of CHE defined as more than 40% of non-food expenditure rose over the study period, 2011-2015, from 20.86% (95% CI: 19.35% to 22.37%) to 31.00% (95% CI: 29.28% to 32.72%). The intensity of CHE also increased. The overshoot (O) based on non-food expenditure rose from 3.12% (95% CI: 2.71% to 3.53%) to 8.75% (95% CI: 8.14% to 9.36%), while the mean positive overshoot (MPO) rose from 14.96% (95% CI: 12.99% to 16.92%) to 28.23% (95% CI: 26.26% to 30.19%). Thus, the problem of CEH was even more serious in 2015 than in 2011. Logistic regression revealed that households were more likely to face CHE if they had a spouse as a household member, reported an inpatient event in the last year, reported an outpatient visit in the last month, were disabled, were members of a poor expenditure quartile, lived in the middle and western zones or resided in an urban area. In contrast, CEH was not significantly affected by respondents being older than 75 years or having a chronic health condition, by household size or by insurance type.Conclusions: Key policy recommendations include the gradual improvement of medical assistance and the expansion of the use of health insurance to reduce household liability for health expenditures.Trial Registration: None.

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