Benefit-incidence analysis of government spending on Ministry of Health outpatient services in Jordan

Halasa, Yara A.; Nassar, H.; Zaky, Hassan H. M.

doi:10.26719/2010.16.5.467

Cited by 24 publications

(15 citation statements)

References 2 publications

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“…The burden of OOP expenditures may be a major contributor to the inequity in GHS benefit distribution. High user fees decrease healthcare utilization, and the poor who need medical services but cannot afford them will be excluded from the benefits [ 34 ]. We found that OOP expenditures for outpatient care decreased from 2002 to 2007 in both urban and rural areas, while inpatient expenditures increased in urban areas and remained almost unchanged in rural areas.…”

Section: Discussionmentioning

confidence: 99%

Who Benefits from Government Healthcare Subsidies? An Assessment of the Equity of Healthcare Benefits Distribution in China

et al. 2015

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BackgroundImproving the equitable distribution of government healthcare subsidies (GHS), particularly among low-income citizens, is a major goal of China’s healthcare sector reform in China.ObjectivesThis study investigates the distribution of GHS in China between socioeconomic populations at two different points in time, examines the comparative distribution of healthcare benefits before and after healthcare reforms in Northwest China, compares the parity of distribution between urban and rural areas, and explores factors that influence equitable GHS distribution.MethodsBenefit incidence analysis of GHS progressivity was performed, and concentration and Kakwani indices for outpatient, inpatient, and total healthcare were calculated. Two rounds of household surveys that used multistage stratified samples were conducted in 2003 (13,564 respondents) and 2008 (12,973 respondents). Data on socioeconomics, healthcare payments, and healthcare utilization were collected using household interviews.ResultsHigh-income individuals generally reap larger benefits from GHS, as reflected by positive concentration indices, which indicates a regressive system. Concentration indices for inpatient care were 0.2199 (95% confidence interval [CI], 0.0829 to 0.3568) and 0.4445 (95% CI, 0.3000 to 0.5890) in 2002 (urban vs. rural, respectively), and 0.3925 (95% CI, 0.2528 to 0.5322) and 0.4084 (95% CI, 0.2977 to 0.5190) in 2007. Outpatient healthcare subsidies showed different distribution patterns in urban and rural areas following the redesign of rural healthcare insurance programs (urban vs. rural: 0.1433 [95% CI, 0.0263 to 0.2603] and 0.3662 [95% CI, 0.2703 to 0.4622] in 2002, respectively; 0.3063 [95% CI, 0.1657 to 0.4469] and −0.0273 [95% CI, −0.1702 to 0.1156] in 2007).ConclusionsOur study demonstrates an inequitable distribution of GHS in China from 2002 to 2007; however, the inequity was reduced, especially in rural outpatient services. Future healthcare reforms in China should not only focus on expanding the coverage, but also on improving the equity of distribution of healthcare benefits.

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Section: Discussionmentioning

confidence: 99%

Who Benefits from Government Healthcare Subsidies? An Assessment of the Equity of Healthcare Benefits Distribution in China

et al. 2015

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“…The existing literature has demonstrated that better-off individuals receive more public health subsidies than the poor in many Asian countries and regions that rely heavily on out-of-pocket (OOP) payment. Researchers have also suggested that the poor receive fewer subsidies because they simply cannot afford to pay and so forego treatment [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing equity in benefit distribution of government health subsidy in 2012 across East China: benefit incidence analysis

Chen

Palmer

Liu

2016

Int J Equity Health

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BackgroundImproving the equitable benefit distribution of government health subsidies, particularly among the country’s poorer socioeconomic groups, is a major goal of China’s healthcare sector reform.MethodsBenefit incidence analysis was employed to measure the distribution of government health subsidies by income quintile. The concentration index (CI) of different levels of health care facility in urban and rural areas was calculated. A household survey complete through multistage stratified sampling was conducted in 2013 in urban areas (16,908 respondents) and rural areas (19,525 respondents).ResultsThe overall CI for urban patients was 0.1068 for outpatient care and 0.1237 for inpatient care. For outpatient care, the CI was 0.0795, 0.0465 and 0.3456, respectively, at primary, secondary and tertiary health care facilities; for inpatient care, the CI was −0.2179, 0.0752 and 0.2883 at the corresponding facility levels. The overall CI for rural outpatients was −0.0659 and 0.0036 for inpatients. For outpatient care, the CI was −0.0818, 0.0567 and 0.0271 at primary, secondary and tertiary facilities, respectively; for inpatient care, the CI was −0.0050, 0.0084 and 0.0252 at the corresponding facility levels.ConclusionsChina’s primary level health care facilities were found to have a more equitable benefit distribution of government health subsidies than the secondary- and tertiary- level facilities. Increased government budget allocations and insurance imbursement rates, and the provision of technical support and qualified medical staff to lower-level hospitals were key factors. However, the provision of equal subsidies to all socioeconomic levels was found to be a potential threat to the equity of government health subsidy distribution.

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“…According to the literature, BIA is the net government subsidy weighted by the utilization rate [17,18]. Mathematically, the BIA could be estimated by the formula -Specifically, is number of aged people from a particular MPCE class (j) who are suffering from NCDs and utilizing the public healthcare facilities.…”

Section: Benefit Incidence Analysismentioning

confidence: 99%

Equity in Distribution of Public Subsidy for Noncommunicable Diseases among the Elderly in India: An Application of Benefit Incidence Analysis

Bose

Banerjee

2019

Preprint

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Background: Rapid ageing of the population and increasing non-communicable diseases (NCDs) among the elderly is one of the major public health challenges in India. To achieve the Universal Health Coverage, ever-growing elderly population should have access to needed healthcare, and they should not face any affordability related challenge. As most of the elderly suffers from NCDs and achieving health-equity is a priority, this paper aims to: -study the utilization pattern of healthcare services for treatment of NCDs among the elderly; -estimate the burden of out-of-pocket expenditure for the treatment of NCDs among the elderly and -analyze the extent of equity in distribution of public subsidy for the NCDs among the elderly. Methods: National Sample Survey data (71st round) has been used for the study. Exploratory data analysis and benefit incidence analysis have been applied to estimate the utilization, out-of-pocket expenditure and distribution of public subsidy among economic classes. Concentration curves and indices are also estimated. Results: Results show that public-sector hospitalization for NCDs among the elderly has a pro-rich trend in rural India. However, in urban sector, for both inpatient and outpatient care the poorest class has substantial share in utilization of public facilities. Same result is also observed for rural outpatient care. Analysis shows that out-of-pocket expenditure is very high for both medicine and medical care even in public facilities for all economic groups. It is also observed that medicine has the highest-share in total medical expenses during treatment of NCDs among the elderly in both the region. Benefit incidence analysis shows that the public subsidy has a pro-rich distribution for inpatient care treatment in both the sectors. In case of outpatient care, subsidy share is the maximum among the richest in the urban sector and in the rural region the poorest class enjoys the maximum subsidy benefit. Conclusions: It is evident that a substantial share of the public subsidies is still going to the richer sections for the treatment of NCDs among the elderly. Evidences also suggest that procuring medicines and targeted policies for the elderly are needed to improve utilization and equity in the public healthcare system.

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Benefit-incidence analysis of government spending on Ministry of Health outpatient services in Jordan

Cited by 24 publications

References 2 publications

Who Benefits from Government Healthcare Subsidies? An Assessment of the Equity of Healthcare Benefits Distribution in China

Who Benefits from Government Healthcare Subsidies? An Assessment of the Equity of Healthcare Benefits Distribution in China

Assessing equity in benefit distribution of government health subsidy in 2012 across East China: benefit incidence analysis

Equity in Distribution of Public Subsidy for Noncommunicable Diseases among the Elderly in India: An Application of Benefit Incidence Analysis

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