Determinants of out-of-pocket and catastrophic health expenditure in rural population: A community-based study in a block of Purba Barddhaman, West Bengal

Dalui, Anirban; Banerjee, Sitikantha; Roy, Ramaprasad

doi:10.4103/ijph.ijph_848_20

Cited by 20 publications

(22 citation statements)

References 10 publications

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“…The results obtained by Ghafoori et al also revealed that outpatient expenditures were concentrated on below average income deciles (27). According to the study by Dalui et al in India, the concentration of catastrophic expenditure was higher among poorer households (31). One of the reasons for the discrepancy between our findings and the aforementioned studies may be the difference in medical insurance coverage between the studied populations.…”

Section: Discussioncontrasting

confidence: 85%

Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Ahadinezhad

Khosravizadeh

Alizadeh

et al. 2021

Int J Health Life Sci

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Background: Out-of-pocket payments for medical services may undermine access to medical services and equity in healthcare financing. Objectives: The present study aimed to determine the distribution of the burden of out-of-pocket payments for healthcare services among the households in Qazvin province, Iran. Methods: This descriptive-analytical study was conducted on the urban and rural households in Qazvin province, Iran during 2019 - 2020. Data were obtained from the Statistics Center of Iran (2019 - 2020). The optimal sample size was calculated to be 992 households, and the households were selected via three-stage random cluster sampling. Data were collected using a valid questionnaire and via face-to-face interviews with the household owners. The fair financial contribution index (FFCI), concentration index, and Kakwani index were estimated in the Stata software. Results: The estimated parameters indicated that during the study period (March 21, 2019-March 20, 2020), the FFCI value of the rural and urban households was 0.782 and 0.854, respectively. The out-of-pocket payment concentration index based on income rank was estimated at 0.188 in rural households (P < 0.05) and 0.031 in the urban households. In addition, the Kakwani index of the urban and rural households was calculated to be -0.165 and -0.84, respectively. Conclusions: According to the results, out-of-pocket payments were unequally distributed among the households in Qazvin province in 2019 - 2020. These payments were mostly concentrated on the 5th - 7th deciles of urban households. On the other hand, the out-of-pocket payments during the study period were regressive. To promote financial equity, Qazvin health policymakers must run payment exemptions for low-income groups and also expand the medical insurance coverage and universal coverage of healthcare services.

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Section: Discussioncontrasting

confidence: 85%

Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Ahadinezhad

Khosravizadeh

Alizadeh

et al. 2021

Int J Health Life Sci

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“…One of the important factors respondents mentioned for why consumers/patients visit retail pharmacies for common ailments was the poor access to public health facilities and non-affordable fees for private sector doctors. Previous studies have highlighted that public health facilities are not accessible to a majority of the population, and most Indians rely on the expensive private sector for their healthcare needs [ 35 ]. It takes almost a day for patients to receive treatment from a public facility, making it difficult for people from economically-disadvantaged classes, such as daily-wage laborers, to lose one day of wages in order to receive free treatment.…”

Section: Discussionmentioning

confidence: 99%

Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of Providers’ Perspectives across Two States

2021

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India has one of the highest rates of antimicrobial resistance (AMR) worldwide. Despite being prescription drugs, antibiotics are commonly available over-the-counter (OTC) at retail pharmacies. We aimed to gain insight into the OTC sale of antibiotics at retail pharmacies and to elucidate its underlying drivers. We conducted face-to-face, in-depth interviews using convenience sampling with 22 pharmacists and 14 informal dispensers from 36 retail pharmacies across two Indian states (Haryana and Telangana). Thematic analysis revealed that antibiotics were often dispensed OTC for conditions e.g., fever, cough and cold, and acute diarrhea, which are typically viral and self-limiting. Both Access and Watch groups of antibiotics were dispensed for 1–2 days. Respondents had poor knowledge regarding AMR and shifted the blame for OTC practices for antibiotics onto the government, prescribers, informal providers, cross practice by alternative medicine practitioners, and consumer demand. Pharmacists suggested the main drivers for underlying OTC dispensing were commercial interests, poor access to public healthcare, economic and time constraints among consumers, lack of stringent regulations, and scanty inspections. Therefore, a comprehensive strategy which is well aligned with activities under the National Action Plan-AMR, including stewardship efforts targeting pharmacists and evidence-based targeted awareness campaigns for all stakeholders, is required to curb the inappropriate use of antibiotics.

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“…The gender of the head of the household variable is seen as an effective variable in the low-income group. Some studies report that the gender of the household head affects CHE (Choi et al, 2015;Cleopatra & Eunice, 2018;Dalui et al, 2020). Rashad and Sharaf (2015) stated that if the household head is female, the probability of the household being exposed to CHE decreases, while Cleopatra and Eunice (2018) and Dalui et al (2020) stated the opposite.…”

Section: Discussionmentioning

confidence: 99%

“… employment status of the household head (Yereli et al, 2014;Rashad & Sharaf, 2015;Cleopatra & Eunice, 2018;Tokatlıoğlu & Tokatlıoğlu, 2018;Thu Thuong et al, 2021)  insurance status of the household head (Yardim et al, 2010;Li et al 2013;Yereli et al, 2014;Narcı et al 2015;Tokatlıoğlu & Tokatlıoğlu ,2018;Akhtar et al, 2020;Dalui et al, 2020;Thu Thuong et al, 2021),…”

Section: Literaturementioning

confidence: 99%

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The Determinants of Turkey Household Catastrophic Health Expenditures: A Different Approach by Data Mining

ERCAN

2021

Alphanumeric Journal

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This study aims to determine socioeconomic, demographic, and household characteristics that affect Turkish household catastrophic health expenditure (CHE). Data gathered by TurkStat belonging to 40,033 households for the years 2009-2012 were used in the analysis. In the study, CHE was defined as household health expenditures that were 40% (or above) greater than the capacity pay of the household. CHAID analysis was used to determine characteristics affecting Turkish household CHE. According to the CHAID analysis; income, presence of a sick/disabled person, residential area, household size, age, education level and gender of the household head, presence of individuals aged 65+, presence of people between the ages of zero and five, and access to health institutions have been observed to affect CHE, while the marital status, age, and employment status of the head of the household, or the household type do not affect CHE. The proportion of households exposed to CHE was 0.62%, and the proportion of households making out-of-pocket health expenditure (OOPHE) was 62.71%. It was especially observed that households with low income, with sick/disabled individuals, and those with difficult access to healthcare facilities are more likely to be exposed to CHE. None of the households exposed to CHE has supplementary health insurance.

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Determinants of out-of-pocket and catastrophic health expenditure in rural population: A community-based study in a block of Purba Barddhaman, West Bengal

Cited by 20 publications

References 10 publications

Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of Providers’ Perspectives across Two States

The Determinants of Turkey Household Catastrophic Health Expenditures: A Different Approach by Data Mining

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