IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v16y2018i2d10.1007_s40258-018-0376-8.html
   My bibliography  Save this article

The Determinants of Household Out-of-Pocket (OOP) Medical Expenditure in Rural Bangladesh

Author

Listed:
  • Shamsul Arifeen Khan Mamun

    (American International University)

  • Rasheda Khanam

    (University of Southern Queensland)

  • Mohammad Mafizur Rahman

    (University of Southern Queensland)

Abstract

Background The Government of Bangladesh has a National Healthcare Strategy 2012–2032 that reiterates a goal to achieve universal health coverage (UHC) by the year 2032. To achieve the goal, the government has set up a strategy to reduce the share of out-of-pocket (OOP) expenditure from the current 64% of the total household healthcare costs to 32% at the national level. As the majority of the people live in the rural areas, and the rural people are generally poor, the success of the strategy relies predominantly on any type of pro-poor healthcare policy and strategy. Objective To estimate if there is any feedback effect in the healthcare costs model and to estimate relative contributions of various determinants to OOP medical expenditure in rural Bangladesh. Methods This study used an econometric approach and a system of simultaneous equations models. The OOP expenditure was measured by household medical expenditure, which is a sum of expenditures for medicine, ayurvedic, various kinds of tests, hospitalization, and dental-related, incidental and other health-related costs. The feedback effect hypothesis is tested by the level of statistically significant dependent variables of the three equations used in the system of simultaneous equations model. The relative importance of the determinants of OOP expenditures was measured by the size of standardised coefficients of the determinants. Results There is a feedback effect between the three dependent variables—medical expenditure, sickness of the household members and the selection of healthcare provider. We also find that although the selection of private healthcare facilities is relatively the most important determinant of OOP expenditures in the rural areas, the sickness of the members of a household and the selection of healthcare provider together have a real effect on the OOP expenditure in rural Bangladesh. Conclusions Bangladesh needs a holistic approach to undertake any strategy; private healthcare facilities are relatively the most important source of high medicine costs; hence, the supply of medicine and its price should be given attention on a priority basis for pro-poor policy framing in conjunction with healthcare insurance and motivation to consult doctors rather than pharmacists in case of sickness.

Suggested Citation

  • Shamsul Arifeen Khan Mamun & Rasheda Khanam & Mohammad Mafizur Rahman, 2018. "The Determinants of Household Out-of-Pocket (OOP) Medical Expenditure in Rural Bangladesh," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 219-234, April.
  • Handle: RePEc:spr:aphecp:v:16:y:2018:i:2:d:10.1007_s40258-018-0376-8
    DOI: 10.1007/s40258-018-0376-8
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-018-0376-8
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s40258-018-0376-8?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
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David Prieto & Santiago Lago-Peñas, 2012. "Decomposing the determinants of health care expenditure: the case of Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 19-27, February.
    2. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/GMM estimation and testing," CERT Discussion Papers 0706, Centre for Economic Reform and Transformation, Heriot Watt University.
    3. World Bank, 2015. "World Development Indicators 2015," World Bank Publications - Books, The World Bank Group, number 21634, December.
    4. Christopher F Baum & Mark E. Schaffer & Steven Stillman, 2007. "Enhanced routines for instrumental variables/generalized method of moments estimation and testing," Stata Journal, StataCorp LP, vol. 7(4), pages 465-506, December.
    5. Jeffrey J. Rous & David R. Hotchkiss, 2003. "Estimation of the determinants of household health care expenditures in Nepal with controls for endogenous illness and provider choice," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 431-451, June.
    6. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, January.
    7. Kamat, Vinay R. & Nichter, Mark, 1998. "Pharmacies, self-medication and pharmaceutical marketing in Bombay, India," Social Science & Medicine, Elsevier, vol. 47(6), pages 779-794, September.
    8. Keya Sengupta, 2016. "Determinants of Health Status in India," Springer Books, Springer, edition 1, number 978-81-322-2535-5, June.
    9. Rahkonen, Ossi & Lahelma, Eero & Huuhka, Minna, 1997. "Past or present? Childhood living conditions and current socioeconomic status as determinants of adult health," Social Science & Medicine, Elsevier, vol. 44(3), pages 327-336, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Glenn P. Jenkins & Hope Amala Anyabolu & Pejman Bahramian, 2019. "Family Decision Making on Healthcare Spending: New Evidence for Nigeria," Development Discussion Papers 2019-12, JDI Executive Programs.

    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. Aziz N. Berdiev & James W. Saunoris, 2018. "Corruption and Entrepreneurship: Cross‐Country Evidence from Formal and Informal Sectors," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 831-848, January.
    2. Sènakpon Fidèle A. Dedehouanou & Luca Tiberti & Hilaire G. Houeninvo & Djohodo Inès Monwanou, 2019. "Working while studying: Employment premium or penalty for youth in Benin?," Working Papers PMMA 2019-03, PEP-PMMA.
    3. Sean M. Dougherty, 2014. "Legal Reform, Contract Enforcement and Firm Size in Mexico," Review of International Economics, Wiley Blackwell, vol. 22(4), pages 825-844, September.
    4. Jiao Ji & Oleksandr Talavera & Shuxing Yin, 2018. "The Hidden Information Content: Evidence from the Tone of Independent Director Reports," Working Papers 2018-28, Swansea University, School of Management.
    5. Mao, Luke Lunhua & Zhang, James J. & Connaughton, Daniel P., 2015. "Sports gambling as consumption: Evidence from demand for sports lottery," Sport Management Review, Elsevier, vol. 18(3), pages 436-447.
    6. Sung Hoon Kang & Mark Skidmore & Laura Reese, 2015. "The Effects of Changes in Property Tax Rates and School Spending on Residential and Business Property Value Growth," Real Estate Economics, American Real Estate and Urban Economics Association, vol. 43(2), pages 300-333, June.
    7. Marjan Petreski, 2010. "An Overhaul of a Doctrine: Has Inflation Targeting Opened a New Era in Developing-country Peggers?," FIW Working Paper series 057, FIW.
    8. Brent Bundick, 2015. "Estimating the Monetary Policy Rule Perceived by Forecasters," Economic Review, Federal Reserve Bank of Kansas City, issue Q IV, pages 33-49.
    9. Aziz N. Berdiev & Brandon Gomes & James W. Saunoris, 2023. "Revisiting the nexus between globalisation and the shadow economy: Untying the influences of de jure versus de facto globalisation," The World Economy, Wiley Blackwell, vol. 46(1), pages 27-54, January.
    10. Schwettmann, Lars, 2015. "Decision solution, data manipulation and trust: The (un-)willingness to donate organs in Germany in critical times," Health Policy, Elsevier, vol. 119(7), pages 980-989.
    11. Bellido, Héctor & Molina, José Alberto & Solaz, Anne & Stancanelli, Elena, 2016. "Do children of the first marriage deter divorce?," Economic Modelling, Elsevier, vol. 55(C), pages 15-31.
    12. Jetter, Michael, 2017. "Terrorism and the Media: The Effect of US Television Coverage on Al-Qaeda Attacks," IZA Discussion Papers 10708, Institute of Labor Economics (IZA).
    13. Brockhaus, Jan & Kalkuhl, Matthias & Kozicka, Marta, 2016. "What Drives India’s Rice Stocks? Empirical Evidence," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235659, Agricultural and Applied Economics Association.
    14. Ming Liu & Sumner LaCroix, 2011. "The Impact of Stronger Property Rights in Pharmaceuticals on Innovation in Developed and Developing Countries," Working Papers 201116, University of Hawaii at Manoa, Department of Economics.
    15. Bruno Ćorić & Vladimir Šimić, 2021. "Economic disasters and aggregate investment," Empirical Economics, Springer, vol. 61(6), pages 3087-3124, December.
    16. Sumei Zhang, 2015. "Impacts of Enterprise Zone Policy on Industry Growth," Economic Development Quarterly, , vol. 29(4), pages 347-362, November.
    17. Evžen Kočenda & Karen Poghosyan, 2018. "Export Sophistication: A Dynamic Panel Data Approach," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 54(12), pages 2799-2814, September.
    18. Rajeev K. Goel & Ummad Mazhar & James W. Saunoris, 2021. "Identifying the corrupt cog in the wheel: Dimensions of supply chain logistics and cross‐country corruption," Australian Economic Papers, Wiley Blackwell, vol. 60(4), pages 693-709, December.
    19. Junaid Ahmed & Mazhar Mughal & Inmaculada Martínez‐Zarzoso, 2021. "Sending money home: Transaction cost and remittances to developing countries," The World Economy, Wiley Blackwell, vol. 44(8), pages 2433-2459, August.
    20. Seemab Gillani & Muhammad Nouman Shafiq & Tusawar Iftikhar Ahmad, 2019. "Military Expenditures and Health Outcomes: A Global Perspective," iRASD Journal of Energy and Environment, International Research Association for Sustainable Development (iRASD), vol. 1(1), pages 1-20, June.

    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:spr:aphecp:v:16:y:2018:i:2:d:10.1007_s40258-018-0376-8. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.