Distress financing of out-of-pocket health expenditure in India

2018 ◽  
Vol 23 (1) ◽  
pp. 314-330 ◽  
Author(s):  
Shivendra Sangar ◽  
Varun Dutt ◽  
Ramna Thakur
Keyword(s):  
Health Expenditure ◽  
Distress Financing

scholarly journals Catastrophic Health Expenditure, Distress Financing and Impoverishment due to Out-of-Pocket Expenses for Healthcare among Patients with Chronic Liver Disease: A Cross-sectional Study among Hospitalized Patients in Bangladesh

2021 ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
Mahmudul Hasan
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Health Expenditure ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Hospitalized Patients ◽  
Chronic Liver ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Financing

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p < 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.

scholarly journals Economic burden and catastrophic health expenditure associated with COVID-19 hospitalisations in Kerala, South India

2021 ◽  
Author(s):  
Ronnie Thomas ◽  
Quincy Mariam Jacob ◽  
Sharon Raj Eliza ◽  
Malathi Mini ◽  
Jobinse Jose ◽  
...  
Keyword(s):  
Health Expenditure ◽  
South India ◽  
Study Participant ◽  
Poverty Line ◽  
Catastrophic Health Expenditure ◽  
Medical Expenditure ◽  
Health Coverage ◽  
Cross Sectional ◽  
Hospitalised Patients ◽  
Distress Financing

Introduction - Catastrophic health expenditure during COVID-19 hospitalization has altered the economic picture of households especially in low resource settings with high rates of COVID-19 infection. This study aimed to estimate the Out of Pocket (OOP) expenditure and the proportion of households that incurred catastrophic health expenditures due to COVID-19 hospitalisation in Kerala, South India. Materials and Methods - A cross-sectional study was conducted among a representative sample of 155 COVID-19 hospitalised patients in Kottayam district over four months, using a pretested interview schedule. The direct medical and non-medical costs incurred by the study participant during hospitalisation and the total monthly household expenditure were obtained from the respective COVID-19 affected households. Catastrophic health expenditure was defined as direct medical expenditure exceeding 40% of effective household income. Results - From the study, median and mean Out of Pocket (OOP) expenditures were obtained as USD 93.57 and USD 502.60 respectively. The study revealed that 49.7% of households had Catastrophic health expenditure, with 32.9% having incurred Distress financing. Multivariate analysis revealed being Below poverty line, hospitalisation in private healthcare facility and presence of co-morbid conditions as significant determinants of Catastrophic health expenditure. Conclusion - High levels of Catastrophic health expenditure and distress financing revealed by the study unveils major unaddressed challenges in the road to Universal health coverage.

scholarly journals Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022002
Author(s):  
Prajjwal Pyakurel ◽  
Jaya Prasad Tripathy ◽  
Myo Minn Oo ◽  
Bijay Acharya ◽  
Ujjwal Pyakurel ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Health Expenditure ◽  
Large Scale ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Cost Of Care ◽  
Industrial Workers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Financing

ObjectivesThe study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expenditure (CHE) and distress financing due to hospitalisation and outpatient care among industrial workers in Eastern Nepal.MethodsWe conducted a cross-sectional study involving industrial workers employed in a large-scale industry in Eastern Nepal. Those who were hospitalised in the last 1 year or availed outpatient care within the last 30 days were administered a structured questionnaire to estimate the cost of illness. CHE was defined as expenditure more than 20% of annual household income. Distress financing was defined as borrowing money/loan or selling assets to cope with OOP expenditure on health.ResultsOf 1824 workers eligible for the study, 1405 (77%) were screened, of which 85 (6%) were hospitalised last year; 223 (16%) attended outpatient department last month. The median (IQR) OOP expenditure from hospitalisation and outpatient care was US$124 (71–282) and US$36 (19–61), respectively. Among those hospitalised, the prevalence of CHE and distress financing was found to be 13% and 42%, respectively, and due to outpatient care was 0.4% and 42%, respectively. Drugs and diagnostics account for a large share of direct costs in both public and private sectors. More than 80% sought hospitalisation and outpatient care in a private sector.ConclusionIndustrial workers face significant financial risks due to ill health compared with the general population. Poor utilisation and higher cost of care in public health facilities warrant strengthening of public sector through increased government spending. The labour act 2014 of Nepal should be strictly adhered.

scholarly journals Catastrophic Health Expenditure, Distress Financing and Impoverishment due to Out-of-Pocket Expenses for Healthcare among Patients with Chronic Liver Disease: A Cross-sectional Study among Hospitalized Patients in Bangladesh

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Health Expenditure ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Hospitalized Patients ◽  
Chronic Liver ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Financing

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p < 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.

Empirical analysis of factors influencing the public health expenditure in Malaysia

2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kok Wooi Yap ◽  
Doris Padmini Selvaratnam
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Price Index ◽  
Infant Mortality Rate ◽  
Public Health Expenditure ◽  
The Public ◽  
Empirical Results ◽  
Per Capita

This study aims to investigate the determinants of public health expenditure in Malaysia. An Autoregressive Distributed Lag (ARDL) approach proposed by Pesaran & Shin (1999) and Pesaran et al. (2001) is applied to analyse annual time series data during the period from 1970 to 2017. The study focused on four explanatory variables, namely per capita gross domestic product (GDP), healthcare price index, population aged 65 years and above, as well as infant mortality rate. The bounds test results showed that the public health expenditure and its determinants are cointegrated. The empirical results revealed that the elasticity of government health expenditure with respect to national income is less than unity, indicating that public health expenditure in Malaysia is a necessity good and thus the Wagner’s law does not exist to explain the relationship between public health expenditure and economic growth in Malaysia. In the long run, per capita GDP, healthcare price index, population aged more than 65 years, and infant mortality rate are the important variables in explaining the behaviour of public health expenditure in Malaysia. The empirical results also prove that infant mortality rate is significant in influencing public health spending in the short run. It is noted that macroeconomic and health status factors assume an important role in determining the public health expenditure in Malaysia and thus government policies and strategies should be made by taking into account of these aspects.

The monetary value of disability-adjusted-life-years lost in Kenya in 2017.pdf

2019 ◽  
Author(s):  
Joses Kirigia ◽  
Rose Nabi Deborah Karimi Muthuri
Keyword(s):  
New York ◽  
International Monetary Fund ◽  
Health Expenditure ◽  
Analytical Framework ◽  
World Health ◽  
Gdp Per Capita ◽  
Current Health ◽  
Monetary Value ◽  
Life Years ◽  
Per Capita

<div>A variant of human capital (or net output) analytical framework was applied to monetarily value DALYs lost from 166 diseases and injuries. The monetary value of each of the 166 diseases (or injuries) was obtained through multiplication of the net 2019 GDP per capita for Kenya by the number of DALYs lost from each specific cause. Where net GDP per capita was calculated by subtracting current health expenditure from the GDP per capita. </div><div> </div><p>The DALYs data for the 166 causes were from IHME (Global Burden of Disease Collaborative Network, 2018), GDP per capita data from the International Monetary Fund world economic outlook database (International Monetary Fund, 2019), and the current health expenditure per person data from the WHO Global Health Expenditure Database (World Health Organization, 2019b). A model consisting of fourteen equations was calculated with Excel Software developed by Microsoft (New York).</p><p> </p>

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