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Paying Out-of-Pocket for Health Care in Asia: Catastrophic and Poverty Impact

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Eddy van Doorslaer

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Abstract

Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. The paper describe the magnitude and distribution of OOP payments for health care in 14 countries and territories accounting for 81% of the Asian population. The focus is on expenditures that may be considered catastrophic, in the sense that they absorb a large fraction of household resources, and on the impoverishing effect of payments. Catastrophic impact is measured by the prevalence and intensity of high shares of OOP in total spending and in non-food expenditure. Impoverishment is measured by comparing poverty headcounts and gaps before and after OOP health payments. Presented here is the first cross-country comparisons of the impoverishing effect of OOP payments measured against the international poverty standards of $1 and $2 per person per day. [Equitap WP 2]

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Paper provided by esocialsciences.com in its series Working Papers with number id:823.

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Date of creation: 2007
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Handle: RePEc:ess:wpaper:id:823

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Related research
Keywords: health care financing; health care payments; catastrophic health costs; poverty; Asia; Health Studies; Economics;

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Gustafsson, Bjorn & Li, Shi, 2004. "Expenditures on education and health care and poverty in rural China," China Economic Review, Elsevier, vol. 15(3), pages 292-301. [Downloadable!] (restricted)
  2. Ravallion, Martin & Shaohua Chen, 1996. "What can new survey data tell us about recent changes in distribution and poverty?," Policy Research Working Paper Series 1694, The World Bank. [Downloadable!]
    Other versions:
  3. O'Donnell, Owen & van Doorslaer, Eddy & Rannan-Eliya, Ravi P. & Somanathan, Aparnaa & Adhikari, Shiva Raj & Akkazieva, Baktygul & Harbianto, Deni & Garg, Charu C. & Hanvoravongchai, Piya & Herrin, Ale, 2008. "Who pays for health care in Asia?," Journal of Health Economics, Elsevier, vol. 27(2), pages 460-475, March. [Downloadable!] (restricted)
  4. Chen, Shaohua & Ravallion, Martin, 2001. "How Did the World's Poorest Fare in the 1990s?," Review of Income and Wealth, Blackwell Publishing, vol. 47(3), pages 283-300, September. [Downloadable!] (restricted)
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  5. Fwu-Ranq Chang & Pravin K. Trivedi, 2003. "Economics of self-medication: theory and evidence," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 721-739. [Downloadable!]
  6. Paul Gertler & Jonathan Gruber, 1997. "Insuring Consumption Against Illness," NBER Working Papers 6035, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  7. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March. [Downloadable!]
  8. Ravallion, M., 1998. "Poverty Lines in Theory and Practice," Papers 133, World Bank - Living Standards Measurement.
  9. Chen, Shaohua & Ravallion, Martin, 2004. "How Have the World's Poorest Fared Since the Early 1980s?," Policy Research Working Paper Series 3341, The World Bank. [Downloadable!]
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  10. 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. [Downloadable!]
  11. Angus Deaton, 2004. "Measuring poverty in a growing world (or measuring growth in a poor world)," Working Papers 178, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies.. [Downloadable!]
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  12. Menno Pradhan & Nicholas Prescott, 2002. "Social risk management options for medical care in Indonesia," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 431-446. [Downloadable!]
  13. Krishna, Anirudh, 2004. "Escaping Poverty and Becoming Poor: Who Gains, Who Loses, and Why?," World Development, Elsevier, vol. 32(1), pages 121-136, January. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Supon Limwattananon, 2008. "Equity in Financing Healthcare: Impact of Universal Access to Healthcare in Thailand," Working Papers id:1577, esocialsciences.com. [Downloadable!]
  2. Wagstaff, Adam, 2005. "Health systems in East Asia : what can developing countrieslearn from Japan and the Asian tigers ?," Policy Research Working Paper Series 3790, The World Bank. [Downloadable!]
    Other versions:
  3. Somanathan, Aparnaa, 2008. "The impact of price subsidies on child health care use : evaluation of the Indonesian healthcard," Policy Research Working Paper Series 4622, The World Bank. [Downloadable!]
  4. Wagstaff, Adam & Lindelow, Magnus, 2005. "Can insurance increase financial risk ? The curious case of health insurance in China," Policy Research Working Paper Series 3741, The World Bank. [Downloadable!]
    Other versions:
  5. Hendrik P. van Dalen, 2006. "When Health Care Insurance Does Not Make A Difference – The Case of Health Care ‘Made in China’," Tinbergen Institute Discussion Papers 06-091/1, Tinbergen Institute. [Downloadable!]
  6. Owen O’Donnell, 2006. "Who Pays for Health Care in Asia?," Working Papers id:775, esocialsciences.com. [Downloadable!]
  7. Owen O’Donnell, 2007. "Explaining the Incidence of Catastrophic Expenditures on health care: Comparative Evidence from Asia," Working Papers id:1095, esocialsciences.com. [Downloadable!]
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