IDEAS home Printed from
   My bibliography  Save this article

Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey


  • Wagner, Anita K.
  • Graves, Amy Johnson
  • Reiss, Sheila K.
  • LeCates, Robert
  • Zhang, Fang
  • Ross-Degnan, Dennis


Objectives We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden.Methods We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries.Results Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden.Conclusion To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.

Suggested Citation

  • Wagner, Anita K. & Graves, Amy Johnson & Reiss, Sheila K. & LeCates, Robert & Zhang, Fang & Ross-Degnan, Dennis, 2011. "Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey," Health Policy, Elsevier, vol. 100(2-3), pages 151-158, May.
  • Handle: RePEc:eee:hepoli:v:100:y:2011:i:2-3:p:151-158

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

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

    References listed on IDEAS

    1. Florentine, Julia Buus & Crane, Catherine, 2010. "Suicide prevention by limiting access to methods: A review of theory and practice," Social Science & Medicine, Elsevier, vol. 70(10), pages 1626-1632, May.
    2. Cook, Philip J. & Ludwig, Jens, 2006. "The social costs of gun ownership," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 379-391, January.
    Full references (including those not matched with items on IDEAS)


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

    Cited by:

    1. Faden, Laura & Vialle-Valentin, Catherine & Ross-Degnan, Dennis & Wagner, Anita, 2011. "Active pharmaceutical management strategies of health insurance systems to improve cost-effective use of medicines in low- and middle-income countries: A systematic review of current evidence," Health Policy, Elsevier, vol. 100(2), pages 134-143.
    2. El-Sayed, Abdulrahman M. & Palma, Anton & Freedman, Lynn P. & Kruk, Margaret E., 2015. "Does health insurance mitigate inequities in non-communicable disease treatment? Evidence from 48 low- and middle-income countries," Health Policy, Elsevier, vol. 119(9), pages 1164-1175.
    3. repec:eee:hepoli:v:121:y:2017:i:5:p:481-494 is not listed on IDEAS
    4. Victoria Fan and William Savedoff, 2014. "The Health Financing Transition: A Conceptual Framework and Empirical Evidence - Working Paper 358," Working Papers 358, Center for Global Development.
    5. Fan, Victoria Y. & Savedoff, William D., 2014. "The health financing transition: A conceptual framework and empirical evidence," Social Science & Medicine, Elsevier, vol. 105(C), pages 112-121.


    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:eee:hepoli:v:100:y:2011:i:2-3:p:151-158. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu) or (). General contact details of provider: .

    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.

    We have no references for this item. You can help adding them by using 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.