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The impoverishing effect of adverse health events : evidence from the western Balkans

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  • Mendola, Mariapia
  • Bredenkamp, Caryn
  • Gragnolati, Michele

Abstract

This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia, and Kosovo) have succeeded in providing financial protection against adverse health events. The authors examine disparities in health status, healthcare utilization, and out-of-pocket payments for healthcare (including informal payments), and explore the impact of healthcare expenditures on household economic status and poverty. Methodologies include (i) generating a descriptive assessment of health and healthcare disparities across socioeconomic groups, (ii) measuring the incidence and intensity of catastrophic healthcare payments, (iii) examining the effect of out-of-pocket payments on poverty headcount and poverty gap measures, and (iv) running sets of country-specific probit regressions to model the relationship between health status, healthcare utilization, and poverty. On balance, the findings show that the impact of health expenditures on household economic wellbeing and poverty is most severe in Albania and Kosovo, while Montenegro is striking for the financial protection that the health system seems to provide. Data are drawn from Living Standards and Measurement Surveys.

Suggested Citation

  • Mendola, Mariapia & Bredenkamp, Caryn & Gragnolati, Michele, 2007. "The impoverishing effect of adverse health events : evidence from the western Balkans," Policy Research Working Paper Series 4444, The World Bank.
    • Handle: RePEc:wbk:wbrwps:4444
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    References listed on IDEAS

    as
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    2. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    3. Wagstaff, Adam, 2005. "The economic consequences of health shocks," Policy Research Working Paper Series 3644, The World Bank.
    4. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
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    1. Aran, Meltem A. & Hentschel, Jesko S., 2012. "Protection in good and bad times ? the Turkish green card health program," Policy Research Working Paper Series 6178, The World Bank.
    2. Rama Joglekar, 2008. "Can insurance reduce catastrophic out-of-pocket health expenditure?," Indira Gandhi Institute of Development Research, Mumbai Working Papers 2008-016, Indira Gandhi Institute of Development Research, Mumbai, India.
    3. Yonatan Dinku & David Fielding & Murat Genç, 2018. "Health shocks and child time allocation decisions by households: evidence from Ethiopia," IZA Journal of Labor Economics, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 7(1), pages 1-23, December.
    4. World Bank, 2011. "Albania - Out-of-Pocket Payments in Albania’s Health System : Trends in Household Perceptions and Experiences 2002-2008," World Bank Other Operational Studies 2784, The World Bank.
    5. Yerramilli, Pooja & Fernández, Óscar & Thomson, Sarah, 2018. "Financial protection in Europe: a systematic review of the literature and mapping of data availability," Health Policy, Elsevier, vol. 122(5), pages 493-508.
    6. Afis A Agboola & Oluwaseun T Esan & Oluwasegun T Afolabi & Taiwo A Soyinka & Adedunmola O Oluwaranti & Adeniji Adetayo, 2018. "Economic burden of the therapeutic management of mental illnesses and its effect on household purchasing power," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-13, September.

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    Keywords

    Health Monitoring&Evaluation; Health Systems Development&Reform; Health Economics&Finance; Population Policies; Rural Poverty Reduction;

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