Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Abstract

ObjectivesAs in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh.MethodsA total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method.ResultsThe mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures.ConclusionsThe findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

Magnitude and Factors Affecting Out-of-Pocket Medical Expenditure among Outpatients in ST.Paul Hospital Millennium College, Addis Ababa, Ethiopia

“…The present study is also supported by Various studies that indicates demographic factors like age, sex, marital status, place of residence, and family wealth influence higher OOP health expenditures [16]. According to the present study, Greater percentage of females had higher Out-of-pocket health expenditures compared with male respondents…”

Cost comparison and determinants of out‐of‐pocket payments on child delivery care in Bangladesh

“…Over the last two decades, the private sector engaged in healthcare delivery significantly, which contributed to the increase of institutional delivery and C‐section delivery rates in Bangladesh. However, the C‐section rate is unnecessarily high (23%) and is higher than global standard, often resulting in excessive cost . Nevertheless, the household OOP spending was still the main (67%) payment strategy for healthcare, although the target of the Bangladesh healthcare financing strategy was to reduce the OOP expenditure from 67% to 32% in total health expenditure to assist in the achievement of Universal Health Coverage .…”

“…A log linear regression model was used to sort out the factors of OOP associated with home delivery, institutional normal delivery, C‐section delivery, and the total cost of child delivery services. The variance inflation factor test was used to detect for multicollinearity in the regression model . All data cleaning, validation, and statistical analyses were performed using Stata/SE 13.0 (StataCorp.…”

“…As such, maternal care‐related financial and well‐being costs might be devastating and could significantly impact the livelihoods of family members by causing economic disruption. Indeed, in the case of Bangladesh, many households experience catastrophic economic burden and fall into poverty due to these expenses . Households often mitigate this excessive expenditure by borrowing, selling assets, or using savings, donation from relatives, bank loans, and relying on transfers .…”

Gasto de bolsillo en salud en adultos mayores peruanos: análisis de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2017

“…Se han encontrado diversos factores que se asocian al GBS, como por ejemplo, sexo, edad, área de residencia, nivel de educación, ingresos, presencia de enfermedades crónicas y disponer de un seguro de salud (5)(6)(7)(8)(9)(10)(11)(12) . Así, los adultos mayores con bajos ingresos tienen una mayor proporción de GBS en relación con sus ingresos, un menor nivel educativo se asocia con un mayor GBS, la falta de cobertura de un seguro de salud y el sexo femenino presentan GBS más alto debido a sus menores ingresos y menor tasa de participación laboral (13) .…”