scholarly journals Financial risk protection at the bedside: How Ethiopian physicians try to minimize out-of-pocket health expenditures

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212129 ◽  
Author(s):  
Ingrid Miljeteig ◽  
Frehiwot Berhane Defaye ◽  
Paul Wakim ◽  
Dawit Neema Desalegn ◽  
Yemane Berhane ◽  
...  
Keyword(s):  
Financial Risk ◽  
Health Expenditures ◽  
Financial Risk Protection ◽  
Risk Protection

Treatment as insurance: HIV antiretroviral therapy offers financial risk protection in Malawi

2020 ◽  
Vol 35 (6) ◽  
pp. 676-683
Author(s):  
Sarah Dickerson ◽  
Victoria Baranov ◽  
Jacob Bor ◽  
Jeremy Barofsky
Keyword(s):  
Health Expenditure ◽  
Financial Risk ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Hiv Treatment ◽  
Financial Risk Protection ◽  
Urban Households ◽  
Medical Spending ◽  
Risk Protection ◽  
The Impact

Abstract Many countries have expanded insurance programmes in an effort to achieve universal health coverage (UHC). We assess a complementary path toward financial risk protection: increased access to technologies that improve health and reduce the risk of large health expenditures. Malawi has provided free HIV treatment since 2004 with significant US Government support. We investigate the impact of treatment access on medical spending, capacity to pay and catastrophic health expenditures at the population level, exploiting the phased rollout of HIV treatment in a difference-in-differences design. We find that increased access to HIV treatment generated a 10% decline in medical spending for urban households, a 7% increase in capacity to pay for rural households and a 3-percentage point decrease in the likelihood of catastrophic health expenditure among urban households. These risk protection benefits are comparable to that found from broad-based insurance coverage in other contexts. Our findings show that targeted treatment programmes that provide free care for high burden causes of death can provide substantial financial risk protection against catastrophic health expenditure, while moving developing nations toward UHC.

scholarly journals Distributional health and financial consequences of increased cigarette tax in Iran: extended cost-effectiveness analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Behzad Raei ◽  
Sara Emamgholipour ◽  
Amirhossein Takian ◽  
Mehdi Yaseri ◽  
Ghahreman Abdoli ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Risk ◽  
Health Expenditures ◽  
Cost Effectiveness Analysis ◽  
Cigarette Price ◽  
Financial Risk Protection ◽  
Tax Revenues ◽  
Effectiveness Analysis ◽  
Cigarette Tax ◽  
Risk Protection

Abstract Background To assess the potential impact of a tax-induced cigarette price increase on financial and health outcomes by different socioeconomic groups. Methods In a modeled condition using pooled cross-section data from Household Income and Expenditure Survey (2002–2017) and Iran 2019 population data, a methodology of an extended cost effectiveness analysis (ECEA) was applied to model the impact on cigarette consumption of hypothetically increased cigarette tax. The methodology was employed to evaluate: [1] health benefits (premature deaths averted); [2] health expenditures regarding smoking-related disease treatment averted; [3] additional tax revenues raised; [4] change in household expenditures on cigarettes; and [5] financial risk protection among male Iranian smokers in a time span of 60 years following a one-time increase in cigarette price of 75%. The Stata version 15.1 (StataCorp., College Station, TX, USA) was used to perform the relevant analysis and estimate regression models. Results A 75% increase in cigarettes price through taxation would reduce the number of smokers by more than half a million, 11% of them in the poorest quintile; save about 1.9 million years of life (11% of which would be gained in the lowest quintile compared to 20% in the highest one); eliminate a total of US$196.4 million of health expenditures (9% of which would benefit the bottom quintile). Such a policy could raise the additional annual tax revenues by roughly US$ 1 billion, where the top two quintiles bear around 46% of the total tax burden. We estimated that the tax increase would avert an estimated 56,287 cases of catastrophic expenditure that wholly concentrated among the bottom two expenditure quintiles. Conclusion Increasing cigarette tax can provide health and financial benefits, and would be pro-poor in terms of health gains, Out-of-Pocket (OOP) savings, and financial risk protection against smoking-related diseases.

scholarly journals Examining the density in out-of-pocket spending share in the estimation of catastrophic health expenditures

2021 ◽  
Author(s):  
Abdulrahman Jbaily ◽  
Annie Haakenstad ◽  
Mizan Kiros ◽  
Carlos Riumallo-Herl ◽  
Stéphane Verguet
Keyword(s):  
Financial Risk ◽  
Health Expenditures ◽  
Population Level ◽  
World Health ◽  
Health Coverage ◽  
Access To Health Services ◽  
Financial Risk Protection ◽  
The Sustainable Development ◽  
Catastrophic Health Expenditures ◽  
Risk Protection

AbstractUniversal health coverage (UHC) aims to provide access to health services for all without financial hardship. Moving toward UHC while ensuring financial risk protection (FRP) from out-of-pocket (OOP) health expenditures is a critical objective of the Sustainable Development Goal for Health. In tracking country progress toward UHC, analysts and policymakers usually report on two summary indicators of lack of FRP: the prevalence of catastrophic health expenditures (CHE) and the prevalence of impoverishing health expenditures. In this paper, we build on the CHE indicator: we examine the distribution (density) of health OOP budget share as a way to capture both the magnitude and dispersion in the ratio of households’ OOP health expenditures relative to consumption or income at the population level. We illustrate our approach with country-specific examples using data from the World Health Organization’s World Health Surveys.

Public Insurance and Financial Risk Protection: Lessons from Thailand

2010 ◽  
Author(s):  
Phusit Prakongsai ◽  
Vuthiphan Vongmomgkol ◽  
Warisa Panich-Kriangkrai ◽  
Walaiporn Patcharanarumol ◽  
Viroj Tangcharoensathien
Keyword(s):  
Financial Risk ◽  
Financial Risk Protection ◽  
Public Insurance ◽  
Risk Protection

Making Thailand’s UHC ‘SAFE’ (sustainable, affordable, fair and efficient)

2020 ◽  
Vol 20 (2) ◽  
pp. 231-236
Author(s):  
Somsak Chunharas
Keyword(s):  
Health Services ◽  
Financial Risk ◽  
National Development ◽  
Financial Risk Protection ◽  
Thai Population ◽  
Health Security ◽  
Strategic Purchasing ◽  
Strategic Approach ◽  
Public Sector Health ◽  
Risk Protection

Thai UHC has been established through national efforts to learn from international as well as national development of how to build a system-wide financial risk protection for the Thai population while also ensuring effective coverage of health services. One of the key strategic approach is establishing a strategic purchasing organization called national health security office (NHSO) since 2002. Many lesson have been learnt and shared here hoping that they are generic enough to guide actions and policy decisions either for countries starting UHC or those who have had some models going on. For example, a professionally run strategic purchasing body with certain degree of autonomy is key but the needs to harmonize multiple schemes are also challenging, technically as well as politically. The effective use of and support for existing public sector health services systems is another key lesson. The challenge of making the systems sustainable, affordable fair and efficient have been with us since the very beginning and we shares some of the approaches to address this issue to ensure that UHC will be properly supported politically, professionally managed while maintaining a well balanced demand side with the view to ensure that UHC is creating better health and not merely more access to services.

scholarly journals Spatiotemporal variation and socioeconomic factors of financial hardships of out-of-pocket health expenditure in Pakistan

2021 ◽  
Vol 27 (10) ◽  
pp. 962-973
Author(s):  
Ashar Muhammad Malik ◽  
Iqbal Azam ◽  
Amir Khan ◽  
Faisal Rifaq ◽  
Kinza Chaudhary
Keyword(s):  
Socioeconomic Factors ◽  
Rural Areas ◽  
Health Expenditure ◽  
Financial Risk ◽  
National Level ◽  
Spatiotemporal Variation ◽  
Financial Risk Protection ◽  
Middle Income ◽  
Services Delivery ◽  
Risk Protection

Background: Financial hardships of out-of-pocket health expenditure (OPHE) is a growing concern for health policy makers in many low and middle-income countries. Spatiotemporal variation between Pakistan’s four provinces over 2001-2015 is discussed, which would help comparing existing health services delivery and financial risk protection plans. Aims: In this paper, we estimate financial hardship of OPHE in Pakistan. Methods: We use the data sets of the household integrated economic surveys 2001-02, 2005-06, 2010-11 and 2015-16. We estimate OPHE share in household total and non-subsistence expenditure, catastrophic headcount at the threshold of OPHE ≥ 10% of total expenditure or OPHE ≥ 25% of non-subsistence expenditure. We estimate impoverishment of OPHE using national poverty lines. Finally, we explore socioeconomic factors of financial hardships of OPHE. Results: Over the years, catastrophic headcount and impoverishment of OPHE had decreased at national level (–1.3% points) and in the provinces of Sindh (-7.8% points) and Khyber Pukhtoonkhawa (KPK), (–2.8% points). The province of KPK and the year 2005-06 witnessed the highest incidence of financial catastrophe (26.89% points) and impoverishment (4.8% points) of OPHE. Households in rural areas, in the middle and rich quintiles and those headed by a male were more likely to encounter financial catastrophe and impoverishment due to OPHE. Conclusion: Inter-provincial variation in financial hardships of OPHE provide aide to provincial level priority setting. The high impact of OPHE in the non-poor, in rural areas, and in KPK calls for enhanced targeting of financial risk protection plans.

scholarly journals Factors related to excessive out-of-pocket expenditures among the ultra-poor after discontinuity of PBF: a cross-sectional study in Burkina Faso

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yvonne Beaugé ◽  
Valéry Ridde ◽  
Emmanuel Bonnet ◽  
Sidibé Souleymane ◽  
Naasegnibe Kuunibe ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Financial Risk ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Service Utilisation ◽  
Health Coverage ◽  
Sectional Study ◽  
Financial Risk Protection ◽  
Cross Sectional ◽  
Risk Protection

Abstract Background Measuring progress towards financial risk protection for the poorest is essential within the framework of Universal Health Coverage. The study assessed the level of out-of-pocket expenditure and factors associated with excessive out-of-pocket expenditure among the ultra-poor who had been targeted and exempted within the context of the performance-based financing intervention in Burkina Faso. Ultra-poor were selected based on a community-based approach and provided with an exemption card allowing them to access healthcare services free of charge. Methods We performed a descriptive analysis of the level of out-of-pocket expenditure on formal healthcare services using data from a cross-sectional study conducted in Diébougou district. Multivariate logistic regression was performed to investigate the factors related to excessive out-of-pocket expenditure among the ultra-poor. The analysis was restricted to individuals who reported formal health service utilisation for an illness-episode within the last six months. Excessive spending was defined as having expenditure greater than or equal to two times the median out-of-pocket expenditure. Results Exemption card ownership was reported by 83.64% of the respondents. With an average of FCFA 23051.62 (USD 39.18), the ultra-poor had to supplement a significant amount of out-of-pocket expenditure to receive formal healthcare services at public health facilities which were supposed to be free. The probability of incurring excessive out-of-pocket expenditure was negatively associated with being female (β = − 2.072, p = 0.00, ME = − 0.324; p = 0.000) and having an exemption card (β = − 1.787, p = 0.025; ME = − 0.279, p = 0.014). Conclusions User fee exemptions are associated with reduced out-of-pocket expenditure for the ultra-poor. Our results demonstrate the importance of free care and better implementation of existing exemption policies. The ultra-poor’s elevated risk due to multi-morbidities and severity of illness need to be considered when allocating resources to better address existing inequalities and improve financial risk protection.

Sign in / Sign up

Export Citation Format

Share Document