scholarly journals Health Care Expenditure of Rural Households in Pondicherry, India

2013 ◽  
Vol 1 (2) ◽  
pp. 74-79
Author(s):  
Poornima Varadarajan ◽  
Lopamudra Moharana ◽  
Murugan Venkatesan
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Health Care Expenditure ◽  
Rural Households ◽  
Healthcare Delivery ◽  
Calculated Data ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Income Quintile ◽  
Cross Sectional

Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005) estimates reveal that every year 25 million households are forced into poverty by illness and the stru­ggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selec­ted for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16). Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%. Conclusion: There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.

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 Magnitude of Out of Pocket Health Expenditures and Associated Factors among Civil Servants

2015 ◽  
Vol 4 (4) ◽  
pp. 332
Author(s):  
Mekuanenet Geremew ◽  
Molla Gedefaw ◽  
Girmay Tsegay ◽  
Getachew Mullu Kassa
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Associated Factors ◽  
Health Care Expenditure ◽  
Social Health Insurance ◽  
Simple Random Sampling ◽  
Civil Servants ◽  
Public Health Care ◽  
Cross Sectional ◽  
Study Participants

<p>In Ethiopia, as other developing countries, public health care is provided at nominally low prices and free to those that does not afford to pay. But the health care consumer population is still to make considerable amount of out-of-pocket health expenditure for various reasons. A cross sectional quantitative study from January to May 2013 was done. Study population was civil servants in Debre Markos town. A total of 467<strong> </strong>study participants were selected by using simple random sampling method. Data were collected by trained high school graduates and then the collected data were entered into a computer by using Epi-Data version 3.1 and analysis was performed by using SPSS version 16 for windows. Possible associations between out of pocket health expenditure and its predictors were analyzed by using both bivariate and multivariate analysis.<strong> </strong>The mean age of the study participants were 41 years. Majorities were between 25 and 44 years of age, 258 (55.2%). The level of education among the study participants indicated that most 380 (81.4%) were graduates of higher education (HE) and majority were Orthodox Christian which accounted 446 (95.5%) followed by Muslims 13 (2.8%). To put it briefly, the study identified that the median of out of pocket health care expenditure accounted 8.26% of total household income. Health status of the household (with or without chronic illness), debt on any of the household, house on construction owned by any household member, educational fee for at least one member of the household and predominantly used health institution were the associated factors that have significant impact on household out of pocket health expenditure. <strong>T</strong>here is economic burden as a result of health care at household level.   Based on the results, the recommendation was introducing social health insurance for all civil servant employees in the study area.</p>

scholarly journals Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

2019 ◽  
Vol 3 (5) ◽  
pp. 327-336 ◽  
Author(s):  
Deepak Raj Paudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Expenditure ◽  
Health Care Expenditure ◽  
Catastrophic Health Expenditure ◽  
Health Concern ◽  
Government Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

High expenditure due to health care is a noted public health concern in Nepal and such expenditure is expected to reduce through the access to health insurance. This study determines the factors affecting household’s catastrophic health care expenditure in Kailali district, where the government health insurance program was first piloted in Nepal. A cross-sectional survey was conducted from January to February 2018 among 1048 households (6480 individuals) after 21 months of the execution of the social health insurance program.  For the sample selection, wards were selected in the first stage followed by the selection of the households. Overall, 17.8% of the households reported catastrophic health expenditure using a threshold of more than 10% of out-of-pocket payment to total household expenditure. The study found that households without having health insurance, low economic status, and head with low level of education were more likely to face catastrophic spending. The findings suggest a policy guideline in the ongoing national health insurance debate in Nepal. The government health insurance program is currently at expansion stage, so, increase in insurance coverage, could financially help vulnerable households by reducing catastrophic health expenditure.

scholarly journals Health And Convergence Of Health Care Expenditure In EU

2011 ◽  
Vol 7 (3) ◽  
Author(s):  
Kaie Kerem ◽  
Tiia Puss ◽  
Mare Viies ◽  
Reet Maldre
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Care Expenditure ◽  
World Health ◽  
The European Union ◽  
Cross Sectional ◽  
European Union Enlargement ◽  
Life Expectancy At Birth ◽  
Health Organization ◽  
The Eu

The objective of the paper is to review and analyze the health of population and health care expenditure and to examine the trends of convergence of health care expenditure in EU countries. One of the most often used indicators characterizing a populations health is life expectancy at birth. Comparative analyses show that the life expectancy at birth in EU-12 countries is much lower than in EU-15 countries. Although in 1992-2004 the life expectancy increased both in EU-15 countries and in EU-12 countries, the differences in the life expectancy have still remained more or less the same. Besides the low life expectancy in EU-12 countries, also the resources used in health care are below the EU-15 average level. In our paper we test the ?-, ?- and ?-convergence of the health care expenditure. For testing ?-, ?- and ?-convergence the authors have used cross-sectional data over the period 1992-2004 for health care expenditure as share of GDP and per capita health care expenditure. Data of the World Health Organization (WHO) were used for the research. The study demonstrates that although usually the increase of economic integration facilitates economic growth, the mere fact of the European Union enlargement does not bring along an automatic homogenization of health care expenditure and health policy in the EU-12 countries.

scholarly journals Causality between Economic Growth and Health Expenditure: A time series analysis from 1996 till 2017 in Albania

2020 ◽  
Vol 16 ◽  
Keyword(s):  
Economic Growth ◽  
Health Care ◽  
Human Capital ◽  
Health Expenditure ◽  
Health Care Expenditure ◽  
World Health ◽  
Development Economic ◽  
Causality Test ◽  
Per Capita Gdp ◽  
Per Capita

-Evidence shows that human capital is a leading driver and one of the most important factors affecting economic development. Economic growth models emphasize the effect that human capital has on the growth and prosperity of a country. The indicators used to measure human capital vary. In this article we will use total health expenditure as a measure for human capital. A healthier population will obviously lead to increased productivity and consequently a higher income for the individual. By increasing public health investments, the workforce will potentially be healthier and consequently human productivity will increase. One of the most important lessons to be learned from the coronavirus pandemic is the importance of investments in health care services, human resources and technical infrastructure for the economy. The aim of this article is to study the relationship between Health Care Expenditure (HCE) per capita and Gross Domestic Product GDP per capita in Albania. The data (in $) is taken from the World Health Organization website, for the time period 1996-2017. The methods used are the ARDL Bounds testing approach for co-integration and the Granger causality test. The main results are: the variables per capita GDP and per capita HCE are not cointegrated. The ARDL(1,1) model estimation points out the positive relationship between the two variables. Also, our study confirms the existence of joint causality between per capita GDP and per capita HCE.

Magnitude of Out of Pocket Health Expenditures and Associated Factors among Civil Servants

2015 ◽  
Vol 4 (4) ◽  
pp. 332
Author(s):  
Mekuanenet Geremew ◽  
Molla Gedefaw ◽  
Girmay Tsegay ◽  
Getachew Mullu Kassa
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Associated Factors ◽  
Health Care Expenditure ◽  
Social Health Insurance ◽  
Simple Random Sampling ◽  
Civil Servants ◽  
Public Health Care ◽  
Cross Sectional ◽  
Study Participants

<p>In Ethiopia, as other developing countries, public health care is provided at nominally low prices and free to those that does not afford to pay. But the health care consumer population is still to make considerable amount of out-of-pocket health expenditure for various reasons. A cross sectional quantitative study from January to May 2013 was done. Study population was civil servants in Debre Markos town. A total of 467<strong> </strong>study participants were selected by using simple random sampling method. Data were collected by trained high school graduates and then the collected data were entered into a computer by using Epi-Data version 3.1 and analysis was performed by using SPSS version 16 for windows. Possible associations between out of pocket health expenditure and its predictors were analyzed by using both bivariate and multivariate analysis.<strong> </strong>The mean age of the study participants were 41 years. Majorities were between 25 and 44 years of age, 258 (55.2%). The level of education among the study participants indicated that most 380 (81.4%) were graduates of higher education (HE) and majority were Orthodox Christian which accounted 446 (95.5%) followed by Muslims 13 (2.8%). To put it briefly, the study identified that the median of out of pocket health care expenditure accounted 8.26% of total household income. Health status of the household (with or without chronic illness), debt on any of the household, house on construction owned by any household member, educational fee for at least one member of the household and predominantly used health institution were the associated factors that have significant impact on household out of pocket health expenditure. <strong>T</strong>here is economic burden as a result of health care at household level.   Based on the results, the recommendation was introducing social health insurance for all civil servant employees in the study area.</p>

scholarly journals Has Iran achieved the goal of reducing the prevalence of households faced with catastrophic health expenditure to 1%? The results of a national study

2021 ◽  
Author(s):  
Bakhtiar Piroozi ◽  
Hassan Mahmoodi ◽  
Hossein Safari ◽  
Amjad Mohamadi Bolbanabad ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Expenditure ◽  
Economic Status ◽  
Multivariate Regression Analysis ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
National Study ◽  
Health Coverage ◽  
World Health Survey ◽  
Cross Sectional

Abstract Background Access to universal health coverage and reducing the prevalence of catastrophic health expenditure (CHE) to 1% are the commitments of the Islamic Republic of Iran. The aim of this study was to investigate the prevalence of households exposed to CHE. Methods This cross-sectional study was performed on 2000 households in five provinces of Iran in 2021. Data were collected through interviews using the World Health Survey questionnaire. Results Data from households whose health care costs were more than 40% of their capacity to pay were included in the group of households with CHE. Determinants of CHE were identified using multivariate regression analysis. 8.3% of households were exposed to CHE. The variables of being a female head of household, use of inpatient, outpatient, dental, and rehabilitation services, families with disabled members and low economic status of the households were significantly associated with increased odds of facing CHE. Conclusion In the final year of the sixth five-year development plan, Iran has not yet achieved its goal of "reducing the percentage of households exposed to CHE to 1%," and a high percentage of Iranian households still face CHE. Policymakers should pay attention to factors increasing the chance of facing CHE in designing interventions and this can help the goal of financial protection against health costs.

scholarly journals Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients : evidence from China Family Panel Studies

2020 ◽  
Author(s):  
Xianzhi Fu ◽  
Qi-wei Sun ◽  
Chang-qing Sun ◽  
Fei Xu ◽  
Jun-jian He
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Expenditure ◽  
Communicable Disease ◽  
Rural Households ◽  
Catastrophic Health Expenditure ◽  
System Reform ◽  
Cross Sectional ◽  
Urban Rural ◽  
Panel Studies

Abstract Background: The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.Methods: The second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.Results: The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).Conclusions: Compared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics.

scholarly journals Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

2020 ◽  
Author(s):  
Xian-zhi Fu ◽  
Qi-wei Sun ◽  
Chang-qing Sun ◽  
Fei Xu ◽  
Jun-jian He
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Expenditure ◽  
Communicable Disease ◽  
Rural Households ◽  
Catastrophic Health Expenditure ◽  
System Reform ◽  
Cross Sectional ◽  
Urban Rural ◽  
Panel Studies

Abstract BackgroundThe prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.MethodsThe second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.ResultsThe CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).ConclusionsCompared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics mentioned above.

Aging, health expenditure, proximity to death, and income in Finland

2008 ◽  
Vol 3 (2) ◽  
pp. 165-195 ◽  
Author(s):  
UNTO HÄKKINEN ◽  
PEKKA MARTIKAINEN ◽  
ANJA NORO ◽  
ELINA NIHTILÄ ◽  
MIKKO PELTOLA
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Long Term Care ◽  
Health Care Expenditure ◽  
Term Care ◽  
Age And Gender ◽  
And Gender ◽  
Proximity To Death ◽  
Naive Model

AbstractThis study revisits the debate on the ‘red herring’, i.e. the claim that population aging will not have a significant impact on health care expenditure (HCE), using a Finnish data set. We decompose HCE into several components and include both survivors and deceased individuals into the analyses. We also compare the predictions of health expenditure based on a model that takes into account the proximity to death with the predictions of a naïve model, which includes only age and gender and their interactions. We extend our analysis to include income as an explanatory variable. According to our results, total expenditure on health care and care of elderly people increases with age but the relationship is not as clear as is usually assumed when a naïve model is used in health expenditure projections. Among individuals not in long-term care, we found a clear positive relationship between expenditure and age only for health centre and psychiatric inpatient care. In somatic care and prescribed drugs, the expenditure clearly decreased with age among deceased individuals. Our results emphasize that even in the future, health care expenditure might be driven more by changes in the propensity to move into long-term care and medical technology than age and gender alone, as often claimed in public discussion. We do not find any strong positive associations between income and expenditure for most non-LTC categories of health care utilization. Income was positively related to expenditure on prescribed medicines, in which cost-sharing between the state and the individual is relatively high. Overall, our results indicate that the future expenditure is more likely to be determined by health policy actions than inevitable trends in the demographic composition of the population.

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