IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v34y2019i4pe1569-e1585.html
   My bibliography  Save this article

The impact of out‐of‐pocket health expenditure on household impoverishment: Evidence from Morocco

Author

Listed:
  • Meriem Oudmane
  • Fouzi Mourji
  • Abdeljaouad Ezzrari

Abstract

Health financing in Morocco relies mainly on out‐of‐pocket (OoP) payments. World Health Organization (WHO) has shown that these payments can expose households to catastrophic health expenditure (hereinafter CHE) and impoverish them. The study examines the financial burden of OoP health payments on Moroccan households. Two approaches—that developed by Wagstaff and Doeslear and the one advocated by WHO—are adopted to estimate the extent of CHE. These show that 1.77% of households incurred CHE at the 40% threshold for nonfood expenditure. At the 10% threshold for total consumption expenditure, 12.8% of households incurred CHE. We find that these OoP payments have made 1.11% of Moroccan households poorer. In analyzing the determinants of CHE, we estimated an ordered probit model. It appears that any of (a) hospitalization, (b) presence of an elderly person in the household, or (c) the level of poverty increases significantly the likelihood of health expenditure becoming catastrophic. On the other hand, we find that coverage by health insurance protects against CHE.

Suggested Citation

  • Meriem Oudmane & Fouzi Mourji & Abdeljaouad Ezzrari, 2019. "The impact of out‐of‐pocket health expenditure on household impoverishment: Evidence from Morocco," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1569-1585, October.
    • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:e1569-e1585
    DOI: 10.1002/hpm.2848
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.2848
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hpm.2848?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. De Weerdt, Joachim & Dercon, Stefan, 2006. "Risk-sharing networks and insurance against illness," Journal of Development Economics, Elsevier, vol. 81(2), pages 337-356, December.
    2. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    3. Margaret Grosh & Paul Glewwe, 2000. "Designing Household Survey Questionnaires for Developing Countries," World Bank Publications - Books, The World Bank Group, number 25338, December.
    4. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    5. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    6. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
    7. Yardim, Mahmut Saadi & Cilingiroglu, Nesrin & Yardim, Nazan, 2010. "Catastrophic health expenditure and impoverishment in Turkey," Health Policy, Elsevier, vol. 94(1), pages 26-33, January.
    8. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    9. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health‐care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    2. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    3. Syeda Anam Fatima Rizvi, 2021. "Household Catastrophic Health Expenditures and its Determinants in Pakistan," Post-Print hal-03341700, HAL.
    4. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
    5. Afroza Begum & Syed Abdul Hamid, 2021. "Impoverishment impact of out-of-pocket payments for healthcare in rural Bangladesh: Do the regions facing different climate change risks matter?," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-21, June.
    6. Dhanaraj, Sowmya, 2014. "Health shocks and coping strategies: State health insurance scheme of Andhra Pradesh, India," WIDER Working Paper Series 003, World Institute for Development Economic Research (UNU-WIDER).
    7. Macha, Raphael Rasiel, 2015. "Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 3(2), July.
    8. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    9. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.
    10. Gabriel Picone & Assi José Carlos Kimou & Désiré Kanga, 2023. "Medical emergencies and farm productivity in Côte d'Ivoire," Review of Development Economics, Wiley Blackwell, vol. 27(3), pages 1630-1648, August.
    11. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    12. Ligane Séne & Momath Cissé, 2015. "Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal," International Journal of Health Economics and Management, Springer, vol. 15(3), pages 307-328, September.
    13. Pu Liao & Zhihong Dou & Xingxing Guo, 2021. "The Effect of Health Shock and Basic Medical Insurance on Family Educational Investment for Children in China," IJERPH, MDPI, vol. 18(10), pages 1-16, May.
    14. Zelalem Yilma & Anagaw Mebratie & Robert Sparrow & Degnet Abebaw & Marleen Dekker & Getnet Alemu & Arjun S. Bedi, 2014. "Coping with shocks in rural Ethiopia," Journal of Development Studies, Taylor & Francis Journals, vol. 50(7), pages 1009-1024, July.
    15. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    16. Abdur Razzaque Sarker & Marufa Sultana & Khorshed Alam & Nausad Ali & Nurnabi Sheikh & Raisul Akram & Alec Morton, 2021. "Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2106-2117, November.
    17. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2013. "Measuring the catastrophic and impoverishing effect of household health care spending in Serbia," Social Science & Medicine, Elsevier, vol. 78(C), pages 17-25.
    18. Bernal Lobato, N., 2014. "Essays in applied microeconomics," Other publications TiSEM 9b638b3d-2f83-452a-b2c8-c, Tilburg University, School of Economics and Management.
    19. Dasgupta, Souvik & Kundu, Amit, 2022. "Distress Healthcare Financing among Informal-sector Workers: A Study in Purulia District, West Bengal, India," MPRA Paper 114347, University Library of Munich, Germany, revised 19 May 2022.
    20. Nikolaos Grigorakis & Christos Floros & Haritini Tsangari & Evangelos Tsoukatos, 2017. "Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 261-287, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:34:y:2019:i:4:p:e1569-e1585. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.