Catastrophic health expenditure and entitlement to health services in the occupied Palestinian territory: a retrospective analysis

The Lancet ◽  
2013 ◽  
Vol 382 ◽  
pp. 3 ◽  
Author(s):  
Majdi Ashour ◽  
Ali Abuzaid ◽  
Catherine Korachais
Keyword(s):  
Health Services ◽  
Retrospective Analysis ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure ◽  
Occupied Palestinian Territory ◽  
Palestinian Territory

scholarly journals Changes in Catastrophic Health Expenditures Depending on Health Policies in Turkey

2021 ◽  
Vol 8 ◽  
Author(s):  
Guvenc Kockaya ◽  
Gülpembe Oguzhan ◽  
Zafer Çalşkan
Keyword(s):  
Health Services ◽  
Health Expenditure ◽  
Positive Impact ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Health Policies ◽  
World Health ◽  
Positive Health ◽  
Catastrophic Health Expenditures ◽  
The Impact

Without any financial protection out of pocket health expenses are essential both because their increase causes difficulties in accessing higher quality health services for households and more importantly because it complicates access to most basic health services. As a result of the Health Transformation Program in practice in the Turkish healthcare system since 2003, significant changes have been done in all layers of the health system. Turkish Statistics Institute (TurkStat) publishes the ratio of households that bear catastrophic health expenditures since 2002. According to TurkStat data, the ratio of households with catastrophic expenditure has fallen from 0.81% in 2002 to 0.17% in 2011 with the health transformation project. However, it has started to rise since 2012 and has reached 0.31% in 2014. This study aims to evaluate the expenditure items that may have caused the rise of the ratio of households with catastrophic health expenditures since 2012, which had previously dropped with the Health Transformation Program that has caused fundamental changes in health policies. Methodology and definitions presented in the article named “Distribution of health payments and catastrophic expenditures: Methodology” by Ke Xu published by the World Health Organization in 2005 have been used. Percentages of health expenditure items among the total expenditure of households with positive health expenditure and households with catastrophic health expenditure between 2007 and 2014 have been evaluated using descriptive analysis. Findings have been interpreted in light of the health policies in practice between 2007 and 2014. An overview of the impact of the health policies reveals that medicine expenditures have decreased both for household and public health expenditures. Despite the impact of policies on the pharmaceutical industry was criticized by the industry, the positive impact can be seen by the decrease in the spending on medicine for households spending on health. Hospital service with positive health expenditure is seen to decrease health expenditure. The reasons for the increase in households with catastrophic health expenditure need further research. As a result, the study strives to discuss the possible policy reasons for the observed effects.

scholarly journals Catastrophic health expenditure incidence and its equity in China: a study on the initial implementation of the medical insurance integration system

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Huan Liu ◽  
Hong Zhu ◽  
Jiahui Wang ◽  
Xinye Qi ◽  
Miaomiao Zhao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Low Income ◽  
Health Expenditure ◽  
Concentration Index ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Integration System ◽  
Integration Policies ◽  
The Impact

Abstract Background By 2013, several regions in China had introduced health insurance integration policies. However, few studies addressed the impact of medical insurance integration in China. This study investigates the catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated 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 inequality in 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 those in non-integrated areas. However, households in integrated areas have lower share of out-of-pocket expenditures in the 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. Conclusions The medical insurance integration system in China is still at the exploratory stage; hence, its effects are of limited significance, even though the positive impact of this system on low-income residents is confirmed. Moreover, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and use of health services significantly affect the equity of catastrophic health expenditure incidence and are key issues in the implementation of future insurance integration policies.

Health status and health services in the occupied Palestinian territory

The Lancet ◽  
2009 ◽  
Vol 373 (9666) ◽  
pp. 837-849 ◽  
Author(s):  
Rita Giacaman ◽  
Rana Khatib ◽  
Luay Shabaneh ◽  
Asad Ramlawi ◽  
Belgacem Sabri ◽  
...  
Keyword(s):  
Health Status ◽  
Health Services ◽  
Occupied Palestinian Territory ◽  
Palestinian Territory

scholarly journals Measurement and determinants of financial protection in health in Afghanistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ilker Dastan ◽  
Asiyeh Abbasi ◽  
Chokri Arfa ◽  
Mir Najmuddin Hashimi ◽  
Said Mohammad Karim Alawi
Keyword(s):  
Logistic Regression ◽  
Health Services ◽  
Health Expenditure ◽  
Health Financing ◽  
Catastrophic Health Expenditure ◽  
Financial Hardship ◽  
High Rate ◽  
Financing System ◽  
Total Consumption ◽  
Female Head

Abstract Background Out of pocket (OOP) payments for health are significant health financing challenges in Afghanistan as it is a source of incurrence of catastrophic health expenditure (CHE) and impoverishment. Measuring and understanding the drivers and impacts of this financial health hardship is an economic and public health priority, particularly in the time of COVID-19. This is the first study that measures the financial hardship and determines associated factors in Afghanistan. Methods Afghanistan Living Conditions Survey data for 2016–2017 was used for this study. We calculated incidence and intensity of catastrophic health expenditure by using different thresholds ranging from 5 to 40% of total and nonfood consumption and subsequent impoverishment due to OOPs. Logistic regression was used to assess the degree to which Afghan households are protected from the catastrophic household expenditure. Results Results revealed that 32% of the population in Afghanistan incurred catastrophic health expenditure (as 10% of total consumption) and when healthcare payments are netted out of household consumption, the Afghan population live in extreme poverty ($1.9 in 2011 PPP), increased from 29 to 36%. Based on our findings from logistic regression in Afghanistan, having an educated head or being employed are protective factors from financial hardship while having a female head, an elderly member, a disabled, or a sick member are the risk factors of facing catastrophic health expenditure. Moreover, the people living in rural/nomadic areas or facing an economic shock are more likely to face catastrophic health expenditure and hence to be impoverished due to direct OOPs on health. Conclusions The high rate of poverty and catastrophic health expenditure in Afghanistan emphasizes the need to strengthen the health financing system. Although Afghanistan has made great efforts to support households against health expenditure burden during the pandemic, households are at higher risk of poverty and financial hardship due to OOPs. Therefore, there is need for more financial and supportive response policies by providing a better and easier access to primary health services, extending to all entitlement to health services particularly in the public sector, eliminating user fees for COVID-19 health services and suspending fees for other essential health services, expanding coverage of income support, and strengthening the overall health financing system.

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

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