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

Author

Listed:
  • Abdulrahman Jbaily

    (Harvard T.H. Chan School of Public Health)

  • Annie Haakenstad

    (Harvard T.H. Chan School of Public Health)

  • Mizan Kiros

    (Ethiopian Health Insurance Agency)

  • Carlos Riumallo-Herl

    (Erasmus University)

  • Stéphane Verguet

    (Harvard T.H. Chan School of Public Health)

Abstract

Universal 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.

Suggested Citation

  • Abdulrahman Jbaily & Annie Haakenstad & Mizan Kiros & Carlos Riumallo-Herl & Stéphane Verguet, 2022. "Examining the density in out-of-pocket spending share in the estimation of catastrophic health expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 903-912, July.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:5:d:10.1007_s10198-021-01316-x
    DOI: 10.1007/s10198-021-01316-x
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    References listed on IDEAS

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    1. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    2. Flores, Gabriela & O’Donnell, Owen, 2016. "Catastrophic medical expenditure risk," Journal of Health Economics, Elsevier, vol. 46(C), pages 1-15.
    3. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    4. Adam Wagstaff & Marcel Bilger & Zurab Sajaia & Michael Lokshin, 2011. "Health Equity and Financial Protection : Streamlined Analysis with ADePT Software," World Bank Publications - Books, The World Bank Group, number 2306, December.
    5. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 32(1), pages 147-189.
    6. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    7. Wagstaff, Adam & Eozenou, Patrick Hoang-Vu, 2014. "CATA meets IMPOV: a unified approach to measuring financial protection in health," Policy Research Working Paper Series 6861, The World Bank.
    8. Ataguba, John Ele-Ojo, 2012. "Reassessing catastrophic health-care payments with a Nigerian case study," Health Economics, Policy and Law, Cambridge University Press, vol. 7(3), pages 309-326, July.
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    More about this item

    Keywords

    Financial risk protection; Out-of-pocket health expenditures; Catastrophic health expenditures; Universal health coverage; Equity;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

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