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Out-of-Pocket Health Care Expenditure in Turkey: Analysis of the Household Budget Surveys 2002-2008

  • Dilek Basar

    (Department of Economics, Hacettepe University)

  • Sarah Brown


    (Department of Economics, The University of Sheffield)

  • Arne Risa Hole


    (Department of Economics, The University of Sheffield)

This paper analyses the prevalence of ‘catastrophic’ out-of-pocket health expenditure in Turkey and identifies the factors which are associated with its risk using the Turkish Household Budget Surveys from 2002 to 2008. A sample selection approach based on Sartori (2003) is adopted to allow for the potential selection problem which may arise if poor households choose not to seek health care due to concerns regarding its affordability. The results suggest that poor households are less likely to seek health care as compared to non-poor households and that a negative relationship between poverty and experiencing catastrophic health expenditure remains even after allowing for such selection bias. Our findings, which may assist policy-makers concerned with health care system reforms, also highlight factors such as insurance coverage, which may protect households from the risk of incurring catastrophic health expenditure.

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Paper provided by The University of Sheffield, Department of Economics in its series Working Papers with number 2012020.

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Length: 26 pages
Date of creation: 2012
Date of revision:
Handle: RePEc:shf:wpaper:2012020
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  1. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non-profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616.
  2. Sulku, Seher Nur & Bernard, Didem M., 2009. "Financial burden of health care expenditures in Turkey: 2002-2003," MPRA Paper 28968, University Library of Munich, Germany.
  3. 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.
  4. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Publishing House "SINERGIA PRESS", vol. 31(3), pages 129-137.
  5. Burcay Erus & Nazli Aktakke, 2012. "Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(3), pages 337-346, June.
  6. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
  7. 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.
  8. Tansel, Aysit, 2002. "Determinants of school attainment of boys and girls in Turkey: individual, household and community factors," Economics of Education Review, Elsevier, vol. 21(5), pages 455-470, October.
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