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Out-of-Pocket Expenditures on Health : A Global Stocktake

Author

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  • Wagstaff,Adam
  • Eozenou,Patrick Hoang-Vu
  • Smitz,Marc-Francois

Abstract

This paper provides an overview of research on out-of-pocket health expenditures, reviewing the various summary measures and the results of multi-country studies using these measures. The paper presents estimates for 146 countries from all World Bank income groups for all summary measures, along with correlations between the summary measures and macroeconomic and health system indicators. Large differences emerge across countries in per capita out-of-pocket expenditures in 2011 international dollars, driven in large part by differences in per capita income and the share of gross domestic product spent on health. The two measures of dispersion or risk -- the coefficient of variation and Q90/Q50 -- are only weakly correlated across countries and not explained by the macroeconomic and health system indicators. Considerable variation emerges in the out-of-pocket health expenditure budget share, which is highly correlated with the incidence of"catastrophic"expenditures. Out-of-pocket expenditures tend to be regressive and catastrophic expenditures tend to be concentrated among the poor when expenditures are assessed relative to income, while expenditures tend to be progressive and catastrophic expenditures tend to be concentrated among the rich when expenditures are assessed relative to consumption. At the extreme poverty line of $1.90-a-day, most impoverishment due to out-of-pocket expenditures occurs among low-income countries.

Suggested Citation

  • Wagstaff,Adam & Eozenou,Patrick Hoang-Vu & Smitz,Marc-Francois, 2019. "Out-of-Pocket Expenditures on Health : A Global Stocktake," Policy Research Working Paper Series 8808, The World Bank.
  • Handle: RePEc:wbk:wbrwps:8808
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    Cited by:

    1. Martin Rama, 2019. "Challenges in Measuring Poverty and Understanding its Dynamics: A South Asian Perspective," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 65(S1), pages 2-32, November.
    2. Zlatko Nikoloski & Alistair McGuire & Elias Mossialos, 2021. "Evaluation of progress toward universal health coverage in Myanmar: A national and subnational analysis," PLOS Medicine, Public Library of Science, vol. 18(10), pages 1-18, October.

    More about this item

    Keywords

    Health Care Services Industry; Inequality; Health Economics&Finance; Labor&Employment Law;
    All these keywords.

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