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Disease-specific Impoverishment Impact of Out-of-Pocket Payments for Health Care: Evidence from Rural Bangladesh

Author

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  • Syed Abdul Hamid
  • Syed M. Ahsan

Abstract

This paper examines disease-specific impoverishment impact of out-of-pocket (OOP) payments using a dataset of 3,941 households obtained from a survey conducted in 120 villages of seven districts in Bangladesh. We have estimated the poverty impact of OOP payments by comparing the difference between the average level of headcount poverty and poverty gap with and without health care payments. We find that OOP payments annually push 3.4 percent households into poverty in rural Bangladesh. The corresponding figures for those who had NCDs (non-communicable diseases), chronic illness, hospitalization and catastrophic illness respectively were 4.61, 4.65, 14.53 and 17.33 percent. Note that NCDs are the major part of the latter two situations (about 88% and 85% respectively). Looking into individual categories of NCDs we find that headcount impoverishment impact was immense for cholecystectomy, mental disorder, kidney disease, cancer and appendectomy. The impact on the intensity of impoverishment is the largest among the hospitalized patients and more individually among cancer patients. Hence, NCDs particularly chronic NCDs and those requiring immediate surgical procedures should be given more priority for policy framing. In addition to adopting some ex-ante measures (e.g. raising awareness regarding the risk factors causing NCDs), the paper argues for reforms to enhance efficiency in the public health care facilities and increasing quality of public health care.

Suggested Citation

  • Syed Abdul Hamid & Syed M. Ahsan, 2014. "Disease-specific Impoverishment Impact of Out-of-Pocket Payments for Health Care: Evidence from Rural Bangladesh," Working Papers 27, Institute of Microfinance (InM).
    • Handle: RePEc:imb:wpaper:27
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    Cited by:

    1. Steven F Koch & Naomi Setshegetso, 2020. "Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    2. 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.
    3. Asankha Pallegedara, 2018. "Impacts of chronic non-communicable diseases on households’ out-of-pocket healthcare expenditures in Sri Lanka," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 301-319, September.
    4. 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.
    5. Samuel López-López & Raúl Pozo-Rubio & Marta Ortega-Ortega & Francisco Escribano-Sotos, 2022. "Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1187-1201, September.
    6. Hamid, Syed Abdul, 2014. "Designing an Health Insurance Scheme for Government Employees in Bangladesh: A Concept Paper," MPRA Paper 62841, University Library of Munich, Germany.
    7. Anupa Rijal & Tara Ballav Adhikari & Jahangir A M Khan & Gabriele Berg-Beckhoff, 2018. "The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-23, November.
    8. Abdur Razzaque Sarker & S M Zulfiqar Ali & Maruf Ahmed & S M Zahedul Islam Chowdhury & Nausad Ali, 2022. "Out-of-pocket payment for healthcare among urban citizens in Dhaka, Bangladesh," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-20, January.
    9. Biplab Kumar Datta & Muhammad Jami Husain & Sohani Fatehin & Deliana Kostova, 2018. "Consumption displacement in households with noncommunicable diseases in Bangladesh," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-12, December.
    10. Syed Abdul Hamid & Md. Habibullah Talukder & Afrida Tasnim & Muhammad Ihsan- Ul- Kabir, 2021. "Financing Cancer Care in Bangladesh: An Alternative Route," International Journal of Social and Administrative Sciences, Asian Economic and Social Society, vol. 6(1), pages 1-7, June.
    11. Attila N Lázár & Helen Adams & W Neil Adger & Robert J Nicholls, 2020. "Modelling household well-being and poverty trajectories: An application to coastal Bangladesh," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-23, September.
    12. Nazmul Islam, Muhammed & Rabbani, Atonu & De Allegri, Manuela & Sarker, Malabika, 2024. "Medical treatment loans and their effects on health care utilization and out-of-pocket expenditure: Evidence from an experiment in northern Bangladesh," World Development, Elsevier, vol. 184(C).

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