scholarly journals Ten best resources for conducting financing and benefit incidence analysis in resource-poor settings

2014 ◽  
Vol 30 (8) ◽  
pp. 1053-1058 ◽  
Author(s):  
Virginia Wiseman ◽  
Augustine Asante ◽  
Jennifer Price ◽  
Andrew Hayen ◽  
Wayne Irava ◽  
...  
Keyword(s):  
Health Care ◽  
Service Use ◽  
Health Care Financing ◽  
Health Sector ◽  
Health Financing ◽  
Universal Coverage ◽  
Middle Income ◽  
Country Level ◽  
Benefit Incidence Analysis ◽  
Incidence Analysis

Abstract Many low- and middle-income countries are seeking to reform their health financing systems to move towards universal coverage. This typically means that financing is based on people’s ability to pay while, for service use, benefits are based on the need for health care. Financing incidence analysis (FIA) and benefit incidence analysis (BIA) are two popular tools used to assess equity in health systems financing and service use. FIA studies examine who pays for the health sector and how these contributions are distributed according to socioeconomic status (SES). BIA determines who benefits from health care spending, with recipients ranked by their relative SES. In this article, we identify 10 resources to assist researchers and policy makers seeking to undertake or interpret findings from financing and benefit incidence analyses in the health sector. The article pays particular attention to the data requirements, computations, methodological challenges and country level experiences with these types of analyses.

scholarly journals Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective

2021 ◽  
Author(s):  
Andrea M. Leiter ◽  
Engelbert Theurl
Keyword(s):  
Health Care ◽  
Panel Data ◽  
Health Care Financing ◽  
Value Added ◽  
The Elderly ◽  
Dynamic Panel Data ◽  
Individual Characteristics ◽  
Minor Importance ◽  
Data Set ◽  
Country Level

AbstractIn this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii) the share of compulsory health insurance as percent of total compulsory prepaid financing. In the econometric analysis, we refer to a panel data set comprising 154 countries and covering the time period 2000–2015. We apply a static as well as a dynamic panel data model. We find that the current structure of prepaid financing is significantly determined by its different forms in the past. The significant influence of GDP per capita, governmental revenues, the agricultural value added, development assistance for health, degree of urbanization and regulatory quality varies depending on the financing structure we look at. The share of the elderly and the education level are only of minor importance for explaining the variation in a country’s share of prepaid health care financing. The importance of the mentioned variables as determinants for prepaid health care financing also varies depending on the countries’ socio-economic development. From our analysis we conclude that more detailed information on indicators which reflect the distribution of individual characteristics (such as income, family size and structure and health risks) within a country’s population would be needed to gain deeper insight into the decisive determinants for prepaid health care financing.

scholarly journals Inequality in physical activity, global trends by income inequality and gender in adults

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chastin SFM ◽  
J. Van Cauwenberg ◽  
L. Maenhout ◽  
G. Cardon ◽  
E. V. Lambert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Income Inequality ◽  
Physical Inactivity ◽  
World Health ◽  
Middle Income ◽  
Physical Activity Guidelines ◽  
Middle Income Countries ◽  
Country Level ◽  
The World

Abstract Background Physical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity. Methods Two thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent. Results Significantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries. Conclusions Economic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction.

scholarly journals Exploring the determinants of catastrophic health expenditure and socioeconomic horizontal equity in relation to it: a rural community based longitudinal study in West Bengal

2018 ◽  
Vol 5 (6) ◽  
pp. 2522 ◽  
Author(s):  
Abhishek Paul ◽  
Suresh Chandra Malick ◽  
Shatanik Mondal ◽  
Saibendu Kumar Lahiri
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Concentration Index ◽  
Healthcare Expenditure ◽  
Health Care Financing ◽  
Catastrophic Health Expenditure ◽  
Horizontal Equity ◽  
Income Quintile ◽  
Financing System ◽  
Middle Income

Background:Equity in health care is defined as equal access to available care for equal need. Out-of-pocket expenditures are the most inequitable means of health care financing. These payments become catastrophic health expenditure (CHE) if it exceeds the household’s ‘Capacity to Pay’. As fairness is one of the fundamental objectives of the health system, identification of the factors responsible for these expenditures is important. Hence this study was conducted to find out the determinants of CHE and to explore the socioeconomic horizontal equity in relation to it. Methods:Total 352 households from 9 villages of Amdanga block, North 24 Parganas, were studied for 12 months. Annual out-of-pocket healthcare expenditure exceeding 40% of annual household non-food expenditure was classified as CHE and determinants of the same were identified using logit-model. Equity was measured by Concentration index and modified Kakwani measure (MDK). Results:Overall prevalence of CHE was 20.7% and highest (39.3%) in the second income quintile. The odds of incurring CHE were highest (35.43) for the households with member/s requiring inpatient treatment followed by households having more than five members (12.81). Negative value of concentration index and MDK indicated that the probability of incurring CHE was disproportionately concentrated among the poor and the financing system was degressive, however some amount of equity was noted in the poorest quintile. Conclusions:Apart from the poorest section in the community the poorer and middle income sections are still exposed to healthcare expenditure shocks and the health care spending was diverse and less equitable.

scholarly journals Health financing changes in the context of health care decentralization: the case of three Latin American countries

2000 ◽  
Vol 34 (5) ◽  
pp. 449-460 ◽  
Author(s):  
Armando Arredondo ◽  
Irene Parada
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Sector ◽  
Health Financing ◽  
Primary Data ◽  
Second Phase ◽  
Secondary Sources ◽  
Use Of Resources ◽  
Methodological Tool ◽  
Latin American Countries

OBJECTIVE: The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. METHODS: The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector. RESULTS: Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization. CONCLUSIONS: The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.

Making Health Care Truly Affordable after Health Care Reform

2016 ◽  
Vol 44 (4) ◽  
pp. 546-554 ◽  
Author(s):  
Timothy Stoltzfus Jost ◽  
Harold A. Pollack
Keyword(s):  
Health Care ◽  
Low Income ◽  
Cost Sharing ◽  
Health Care Financing ◽  
Recent Analysis ◽  
Financing System ◽  
Middle Income ◽  
Report Data ◽  
Financial Burdens ◽  
Medicaid Expansions

The Affordable Care Act (ACA) is an essential first step toward making health insurance more affordable for lower and moderate income Americans. It has accomplished historic reductions in the proportion of Americans who are uninsured. The number of Americans reporting delaying medical care for financial reasons has declined by approximately one-third since 2010. Medicaid expansions, in particular, have significantly reduced financial burdens and accompanying anxieties experienced by low-income Americans in states that have embraced this opportunity. Consistent with these finding, one recent analysis of credit report data finds that Medicaid expansion was associated with between a $600 and $1000 decline in collection balances among individuals who gained coverage. Notwithstanding these gains, premiums and cost-sharing are still too high for many Americans. And cost-sharing has continued to edge higher for the majority of Americans who have coverage through employer-based plans. Measures to address these challenges must build on the ACA to provide greater protection to millions of Americans and to address continued dissatisfaction with our health care financing system among middle-income Americans.

Access to health care among racialised immigrants to Canada in later life: a theoretical and empirical synthesis

2021 ◽  
pp. 1-25
Author(s):  
Shen (Lamson) Lin
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Service Use ◽  
Health Sector ◽  
Later Life ◽  
Behavioral Model ◽  
Health Care Utilisation ◽  
Capital Adequacy ◽  
World Health

Abstract Evidence that immigrants tend to be underserved by the health-care system in the hosting country is well documented. While the impacts of im/migration on health-care utilisation patterns have been addressed to some extent in the existing literature, the conventional approach tends to homogenise the experience of racialised and White immigrants, and the intersecting power axes of racialisation, immigration and old age have been largely overlooked. This paper aims to consolidate three macro theories of health/behaviours, including Bronfenbrenner's ecological theory, the World Health Organization's paradigm of social determinants of health and Andersen's Behavioral Model of Health Service Use, to develop and validate an integrated multilevel framework of health-care access tailored for racialised older immigrants. Guided by this framework, a narrative review of 35 Canadian studies was conducted. Findings reveal that racial minority immigrants’ vulnerability in accessing health services are intrinsically linked to a complex interplay between racial-nativity status with numerous markers of power differences. These multilevel parameters range from socio-economic challenges, cross-cultural differences, labour and capital adequacy in the health sector, organisational accessibility and sensitivity, inter-sectoral policies, to societal values and ideology as forms of oppression. This review suggests that, counteracting a prevailing discourse of personal and cultural barriers to care, the multilevel framework is useful to inform upstream structural solutions to address power imbalances and to empower racialised immigrants in later life.

scholarly journals Analysis of Health Sector Budget of Nepal

1970 ◽  
Vol 52 (194) ◽  
pp. 811-821 ◽  
Author(s):  
Ram Krishna Dulal ◽  
Angel Magar ◽  
Shreejana Dulal Karki ◽  
Dipendra Khatiwada ◽  
Pawan Kumar Hamal
Keyword(s):  
Public Health ◽  
Health Care ◽  
Fiscal Federalism ◽  
Health Care Services ◽  
Central Government ◽  
Health Sector ◽  
Health Financing ◽  
Political Commitment ◽  
Financing Policy ◽  
Health Budget

Introduction: Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. Methods: An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Results: Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Conclusions: Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.  Keywords: health care; budget; financing; unitary system; federalism.

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