scholarly journals Catastrophic Health Expenditures And Impoverishment In Kenya

2016 ◽  
Vol 12 (15) ◽  
pp. 434 ◽  
Author(s):  
Diana N. Kimani ◽  
Mercy G. Mugo ◽  
Urbanus M. Kioko
Keyword(s):  
Health Care ◽  
Health Care Expenditure ◽  
Health Expenditures ◽  
Chronically Ill ◽  
Health Care Expenditures ◽  
The Poor ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Catastrophic Expenditures

Background: Out-of-pocket health expenditures leave households exposed to the risk of financial catastrophe and poverty whenever they entail significant dissaving or the sale of key household assets. Even relatively small expenditures on health can be financially disastrous for poor households and similarly, large health care expenditures can lead to financial catastrophe and bankruptcy for rich households. Objective: There is increasing evidence that out-of-pocket expenditures act as a financial barrier to accessing health care, and are a source of catastrophic expenditures and impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and impoverishment in Kenya. Methods: Using Kenya Household Health Expenditures and Utilization Survey data of 2007, the study uses both descriptive and econometric analysis to investigate the incidence and intensity of catastrophic health expenditures and impoverishment as well as the determinants of catastrophic health expenditures. To estimate the incidence and intensity of catastrophic expenditures and impoverishment, the study used both Wagstaff and van Doorslaer, (2002) and Xu et al. (2005) and applied various thresholds to demonstrate the sensitivity of catastrophic measures. For determinants of catastrophic health expenditures, a logit model was employed. Findings: Among those who utilized health care, 11.7 percent experienced catastrophic expenditures and 4 percent were impoverished by health care payments. In addition, approximately 2.5 million individuals were pushed into poverty as a result of paying for health care. The poor experienced the highest incidence of catastrophic expenditures. Conclusion: The paper recommends that the government should establish avenues for reducing the burden of out-of-pocket expenditures borne by households. This could be through a legal requirement for everyone to belong to a health insurance and targeting the poor, the elderly and chronically ill through the devolved system of the government and devolved funds.

The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Saeed Asefzadeh ◽  
Bahman Ahadi Nezhad ◽  
Saeed Norouzi
Keyword(s):  
Health Expenditures ◽  
Medical Costs ◽  
Healthcare Services ◽  
Disease Diagnosis ◽  
Cross Sectional Survey ◽  
Diagnostic Laboratory ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
Catastrophic Expenditures

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

scholarly journals Examining the incidence of catastrophic health expenditures and its determinants using multilevel logistic regression in Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248752
Author(s):  
Atupele N. Mulaga ◽  
Mphatso S. Kamndaya ◽  
Salule J. Masangwi
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Health Services ◽  
Health Expenditures ◽  
Free Access ◽  
Public Health Services ◽  
Factors Associated ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
Catastrophic Expenditures

Background Despite a free access to public health services policy in most sub-Saharan African countries, households still contribute to total health expenditures through out-of-pocket expenditures. This reliance on out-of-pocket expenditures places households at a risk of catastrophic health expenditures and impoverishment. This study examined the incidence of catastrophic health expenditures, impoverishing effects of out-of-pocket expenditures on households and factors associated with catastrophic expenditures in Malawi. Methods We conducted a secondary analysis of the most recent nationally representative integrated household survey conducted by the National Statistical Office between April 2016 to 2017 in Malawi with a sample size of 12447 households. Catastrophic health expenditures were estimated based on household annual nonfood expenditures and total household annual expenditures. We estimated incidence of catastrophic health expenditures as the proportion of households whose out-of-pocket expenditures exceed 40% threshold level of non-food expenditures and 10% of total annual expenditures. Impoverishing effect of out-of-pocket health expenditures on households was estimated as the difference between poverty head count before and after accounting for household health payments. We used a multilevel binary logistic regression model to assess factors associated with catastrophic health expenditures. Results A total of 167 households (1.37%) incurred catastrophic health expenditures. These households on average spend over 52% of household nonfood expenditures on health care. 1.6% of Malawians are impoverished due to out-of-pocket health expenditures. Visiting a religious health facility (AOR = 2.27,95% CI:1.24–4.15), hospitalization (AOR = 6.03,95% CI:4.08–8.90), larger household size (AOR = 1.20,95% CI:1.24–1.34), higher socioeconomic status (AOR = 2.94,95% CI:1.39–6.19), living in central region (AOR = 3.54,95% CI:1.79–6.97) and rural areas (AOR = 5.13,95% CI:2.14–12.29) increased the odds of incurring catastrophic expenditures. Conclusion The risk of catastrophic health expenditures and impoverishment persists in Malawi. This calls for government to improve the challenges faced by the free public health services and design better prepayment mechanisms to protect more vulnerable groups of the population from the burden of out-of-pocket payments.

scholarly journals Gambaran Out of Pocket pada Awal Era JKN di Indonesia

2018 ◽  
pp. 141-146
Author(s):  
Ingan Tarigan ◽  
Taty Suryati
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Financial Protection ◽  
Health Coverage ◽  
Medical Expenses ◽  
The Poor ◽  
The Government ◽  
Universal Health

Abstrak Pogram Jaminan Kesehatan Nasional (JKN) salah satunya bertujuan memberikan perlindungan finansial khususnya biaya katastropik terhadap semua peserta. Penerima manfaat JKN berhak mendapatkan berbagai layanan sebagai bagian dari paket manfaat dasar tanpa mengeluarkan biaya pelayanan, dan diharapkan Out of Pocket (OOP) akan lebih rendah dibandingkan dengan mereka yang tidak memiliki asuransi kesehatan. Tujuan penulisan akan membandingkan total pengeluaran untuk kesehatan dari peserta jaminan kesehatan dengan yang tidak memiliki jaminan kesehatan pada awal era JKN. Dalam analisis ini, pengukuran pengeluaran perawatan kesehatan hanya mencakup biaya pengobatan langsung, seperti biaya konsultasi, pemakaian kamar di rumah sakit dan obat-obatan. Analisis dengan menggunakan data Susenas 2014 terdiri dari 274.673 individu dan 71.051 rumah tangga di 33 provinsi di Indonesia. Hasil penelitian menunjukkan bahwa pada awal era JKN ada sedikit perbedaan OOP pada penduduk miskin dibandingkan dengan penduduk dimana proteksi finansial terhadap penduduk miskin untuk pengeluaran kesehatan masih rendah.Kepemilikan jaminan kesehatan memberikan proteksi finansial akibat pengeluaran biaya kesehatan, khususnya pengeluaran biaya katastropik dibandingkan dengan yang tidak memiliki jaminan kesehatan. Kepesertaan penduduk miskin ditargetkan tahun 2019 sudah terpenuhi sehingga target pemerintah tentang Universal Health Coverage (UHC) perlindungan finansial pada penduduk miskin dan hampir miskin semakin tinggi atau OOP semakin mendekati nol. Kata kunci: OOP, Pembiayaan, Asuransi Kesehatan Abstract One of the main objectives of the JKN program is to provide financial protection, especially catastrophic costs to all members. JKN beneficiaries are entitled to various services as part of the basic benefit package without incurring service costs, and it is expected that Out of Pocket (OOP) will be lower than those who do not have health insurance. The purpose of writing will be to compare the total health expenditures of health insurance participants or beneficiaries and those without health insurance. In this analysis, the measurement of health care expenditures only includes direct medical expenses, such as consultation fees, hospital room usage and medication. Using Susenas data 2014 consists of 274,673 individuals and 71,051 households in 33 provinces in Indonesia. At the beginning of the JKN implementation, there was little difference of out of pocket in the poorest population compared to the richest population. This shows that financial protection to the poor for health expenditures are still low. The ownership of health insurance tends to provide financial protection due to health expenditures, especially catastrophic expenses compared to those without health insurance. In the Year of 2019 where the government targeted to Universal Health Coverage (UHC) expected protection financial on the poor and near poor is getting higher or out of pocket or getting closer up to zero. Keywords: OOP, Financial Protection, Health Insurance

scholarly journals Determinants of out of pocket healthcare expenditures: The case of Mugla province in Turkey

2019 ◽  
Vol 9 (2) ◽  
pp. 76-83
Author(s):  
Bilge Senturk ◽  
Aysun Danisman Isik ◽  
Cisel Ekiz Gokmen
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
Health Expenditures ◽  
Least Square Method ◽  
Health Care Expenditures ◽  
Least Square ◽  
Health Coverage ◽  
Ordinary Least Square ◽  
Income Status ◽  
Out Of Pocket Payments

As the share of health care financing from public funds was increasing in Turkey, the utilization of the health care services has also increased, dramatically. Despite of universal health coverage, the result of this trend causes to increase the incidence of making out of pocket expenditures. The aim of this study is to evaluate the determinants of households’ health expenditures in Mugla province of Turkey. A total of 204 households living in the central district of Mugla were surveyed and questioned both for their total consumption and health expenditures, as well as their health status, demographic and socio-economic characteristics. Ordinary least square method was used for the multiple regression analysis to identify the factors that affect the out of pocket health care expenditures. In addition to other empirical studies in Turkey, the effects of relative poverty and types of income and occupation on oop expenditures were estimated. Results identify that consumption expenditure of the household, poverty, wage/income status, education, household size, having chronic disease and having elderly in the households have significant effects on the amount of out of pocket (oop) health expenditure of the households. Keywords: Health care financing; Out of pocket payments; Ordinary least square method; Turkey

scholarly journals National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008

2011 ◽  
Vol 29 (20) ◽  
pp. 2821-2826 ◽  
Author(s):  
Didem S.M. Bernard ◽  
Stacy L. Farr ◽  
Zhengyi Fang
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Chronically Ill ◽  
Medical Expenditure ◽  
Never Married ◽  
Patients With Cancer ◽  
Nationally Representative ◽  
Total Burden

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.

WHICH HEALTH FINANCING MODEL IS BETTER: TAX-FINANCED OR SOCIAL HEALTH INSURANCE? WHAT DOES INTERNATIONAL EXPERIENCE PROVE?

2021 ◽  
Vol 67 (1) ◽  
pp. 9-9
Author(s):  
E.G. Potapchik ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Structural Characteristics ◽  
Health Expenditures ◽  
Health Financing ◽  
Health Care Expenditures ◽  
Developed Countries ◽  
Financing System ◽  
Financing Model ◽  
The Developed Countries

In Russia disputes on the need to abandon Compulsory Health Insurance (CHI) and return to the tax-based financing are yet to subside. At present, after the statement of the President of the Russian Federation V. Putin about the possibility to establish a state health care corporation, discussions on the issue have only escalated. Purpose. To conduct a comparative assessment of the public health financing model impact on the access and structural characteristics of health care delivery in the developed countries. Material and methods. Assessment of the potential impact of public funding models on the health system performance is carried out by analyzing variations in the main indicators of financial access, health care uptake and health status of the population, achieved in the developed countries with different health financing models. Results. Health care expenditures in countries with CHI are higher than in countries with the tax-based financing model. In countries with CHI the share of administrative expenses is slightly higher than in countries with the tax-based financing system. The share of spending on preventive care is slightly higher in countries with the tax-based financing system. There is a slightly lower level of outpatient and inpatient care uptake in countries with the tax-based financing system compared to countries with CHI. The premature mortality rate in countries with CHI is slightly lower than in countries with the tax-based system. Conclusion. The obtained data indicate that there are no significant differences in the access and structural characteristics of medical care in the health care system of the developed countries with different financing models. The main difference remains the level of health expenditures. In countries with CHI, the level of health expenditures is higher than in countries with the tax-based financing, which is largely due to the existence of a separate source of funding. The level of administrative costs in countries with CHI is also higher than in countries with the tax-based system.

SGLT2 inhibitors: A revolution in therapeutics of a major Non-Communicable Disease

2021 ◽  
pp. 1-3
Author(s):  
Muhammad Sami Khan
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Sglt2 Inhibitors ◽  
Care Providers ◽  
Cardiovascular Outcome Trials ◽  
Non Communicable Disease

Pakistan is facing an exorbitant burden of Non-communicable diseases among which Cardiovascular diseases are the most prominent which has not only caused mortality but also posed a big threat on weakened economy and health care system of the country. Amidst of this growing crisis, Sodium glucose co-transporter 2 (SGLT2) inhibitors emerge as a ray of hope by reducing simultaneously the complication and health care expenditure associated with the management of this major mortality-bringing Non-communicable disease. SGLT2 inhibitors, including Dapagliflozin and Empagliflozin, are evidence-based standardized novel anti-diabetic agents tested in cardiovascular outcome trials namely DAPA-HF and EMPEROR-Reduced, when added to standard care in heart failure patients with reduced ejection fraction, provides breakthrough heart failure outcomes and also addresses massive health care expenditures. This novel finding provides an impetus to promote its beneficial effects among health care providers and early implementation. Continuous....

The relationships between obesity-increasing risk factors for public health, environmental impacts, and health expenditures worldwide

2018 ◽  
Vol 29 (1) ◽  
pp. 131-147 ◽  
Author(s):  
Eduardo Botti Abbade
Keyword(s):  
Public Health ◽  
Health Care ◽  
Environmental Impact ◽  
Environmental Impacts ◽  
Health Care Cost ◽  
Health Care Systems ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Public Health Care ◽  
Content Type

Purpose The purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide. Design/methodology/approach This ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses. Findings Obesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures. Practical implications This study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems. Originality/value This investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.

scholarly journals Poor-quality antimalarials further health inequities in Uganda

2019 ◽  
Vol 34 (Supplement_3) ◽  
pp. iii36-iii47 ◽  
Author(s):  
Daniel R Evans ◽  
Colleen R Higgins ◽  
Sarah K Laing ◽  
Phyllis Awor ◽  
Sachiko Ozawa
Keyword(s):  
Economic Impact ◽  
Early Death ◽  
Wealth Quintile ◽  
Research Impact ◽  
Health Inequities ◽  
Poor Quality ◽  
Rural Populations ◽  
The Poor ◽  
Out Of Pocket Payments ◽  
The Government

Abstract Substandard and falsified medications are a major threat to public health, directly increasing the risk of treatment failure, antimicrobial resistance, morbidity, mortality and health expenditures. While antimalarial medicines are one of the most common to be of poor quality in low- and middle-income countries, their distributional impact has not been examined. This study assessed the health equity impact of substandard and falsified antimalarials among children under five in Uganda. Using a probabilistic agent-based model of paediatric malaria infection (Substandard and Falsified Antimalarial Research Impact, SAFARI model), we examine the present day distribution of the burden of poor-quality antimalarials by socio-economic status and urban/rural settings, and simulate supply chain, policy and patient education interventions. Patients incur US$26.1 million (7.8%) of the estimated total annual economic burden of substandard and falsified antimalarials, including $2.3 million (9.1%) in direct costs and $23.8 million (7.7%) in productivity losses due to early death. Poor-quality antimalarials annually cost $2.9 million to the government. The burden of the health and economic impact of malaria and poor-quality antimalarials predominantly rests on the poor (concentration index −0.28) and rural populations (98%). The number of deaths among the poorest wealth quintile due to substandard and falsified antimalarials was 12.7 times that of the wealthiest quintile, and the poor paid 12.1 times as much per person in out-of-pocket payments. Rural populations experienced 97.9% of the deaths due to poor-quality antimalarials, and paid 10.7 times as much annually in out-of-pocket expenses compared with urban populations. Our simulations demonstrated that interventions to improve medicine quality could have the greatest impact at reducing inequities, and improving adherence to antimalarials could have the largest economic impact. Substandard and falsified antimalarials have a significant health and economic impact, with greater burden of deaths, disability and costs on poor and rural populations, contributing to health inequities in Uganda.

Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

2021 ◽  
pp. 1-9
Author(s):  
David R. Axon ◽  
Jonathan Chien ◽  
Hanh Dinh
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Survey Design ◽  
Health Care Expenditure ◽  
Prescription Medication ◽  
Health Care Expenditures ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Nationally Representative

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

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