Effect of household and village characteristics on financial catastrophe and impoverishment due to health care spending in Western and Central Rural China: A multilevel analysis

Shi, Wenyuan; Chongsuvivatwong, Virasakdi; Geater, Alan; Zhang, Junhua; Zhang, Hong; Brombal, Daniele

doi:10.1186/1478-4505-9-16

Cited by 37 publications

(56 citation statements)

References 24 publications

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“…These households do not have enough money for payment, especially for health care; therefore, they are pushed to the under poverty line. In line with the study, Shi found that households whose head was unemployed were more likely to incur financial catastrophe and impoverishment due to health expenditure (21). In addition, other studies confirm the present study (3,4).…”

Section: Discussionsupporting

confidence: 91%

“…However, the most studies showed that lowest economic group face more than the upper groups (20). A study done in China showed that 36.2 of the house- holds in the lowest economic status were impoverished by health care expenditure (21). The findings of various studies performed in both developing and developed countries have also confirmed the effect of the households' economic status on their being faced with poverty and CHE (16,22,23).…”

Section: Discussionmentioning

confidence: 89%

“…Nevertheless, it is needed to increase access to health services for people in poor regions. In this regards, Shi (21) found that having a hospitalized member in the household is a main factor in health impoverishment and about 29.7 of the households with a hospitalized member are impoverished by health care expenditure.…”

Section: Discussionmentioning

confidence: 99%

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The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

et al. 2018

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Background: Iran's Health Transformation Plan (HTP) was implemented to decrease households' out of pocket and protect them from facing catastrophic health expenditure and impoverishment from 2014. It is needed to assess the effect of HTP; therefore, the study aimed to examine the households' impoverishment due to health expenditure after HTP. Methods: A household survey was carried out in 2017 in Sistan and Baluchestan province in southeast Iran. About 2400 households were selected as the study sample using a multi-stage sampling technique. The household section of the World Health Survey questionnaire was used to collect data. Independent variables contained households' characteristics, household income, chronic illness status, the use of health services, and health spending. The dependent variable was whether the household was faced with health spending impoverishment. Mixed effects logistic regression was used to assess the effect of the independent variables on the impoverishment using SPSS software 21. Results: About 7.5% of the households had no basic insurance and 757 (31.6) heads' of the households were unemployment. The results showed that about 5.4% of the households impoverished due to health expenditure. The households in the furthest region were forced with impoverishment more than other regions (23.0%). Living in a rural area, unemployment, economic status, and inpatients and outpatient costs were the main determinates on impoverishment (P < 0.05). In addition, having supplementary insurance was a protective factor in facing impoverishment (P = 0.05). Conclusions:In general, despite the implementation of HTP, healthcare expenditures leading to impoverishment of high percent of the households and Iranian development goals have not been fulfilled in this region. Economic poverty of the people may also be an important factor in this regard. It is recommended that outpatient services are covered by health insurances.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 89%

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The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

et al. 2018

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“…Saat ini, di Cina, keikutsertaan penderita dalam skema asuransi belum mampu memberi perlindungan terhadap kebangkrutan ekonomi keluarga dalam pembiayaan pelayanan kesehatan penderita yang mengalami penyakit katastropik seperti talasemia ini. 2 Penelitian ini bertujuan untuk menganalisis ability to pay, willingness to pay, dan need assessment pembiayaan kesehatan penderita talasemia di Kabupaten Banyumas.…”

Section: Jurusan Kesehatan Masyarakat Fakultas Kedokteran Dan Ilmu Keunclassified

Analisis Pembiayaan Kesehatan Keluarga Penderita Talasemia

Kurniawan

Intiasari

2013

Kesmas: National Public Health Journal

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AbstrakPembiayaan kesehatan sekitar 146 (60%) penderita talasemia di Banyumas, tahun 2011 ditanggung rumah tangga dalam bentuk pembayaran langsung (out of pocket payment). Penelitian ini bertujuan untuk menganalisis ability to pay, willingness to pay, dan need assessment pembiayaan kesehatan penderita talasemia di Kabupaten Banyumas. Jenis penelitian ini adalah observasional analitik dengan rancangan studi kasus. Penelitian ini menggunakan desain studi cross sectional dengan teknik pengambilan sampel simple random sampling. Jumlah sampel penelitian 30 responden yang mempunyai anggota keluarga penderita talasemia di Kabupaten Banyumas. Hasil penelitian menunjukkan keluarga penderita talasemia mempunyai kemampuan membayar ability to pay rata-rata adalah Rp34.448,8/bulan dan rata-rata willingness to pay pengobatan talasemia adalah Rp133.833,3/ bulan. Pola pembiayaan kesehatan talasemia di Kabupaten Banyumas menggunakan 93,3% Jaminan Kesehatan Masyarakat (Jamkesmas), 3,3% biaya sendiri, dan 3,3% asuransi kesehatan. Sebelum mendapatkan Jamkesmas, 90,0% responden membayar dengan out of pocket, berhutang, berhemat pada kebutuhan nonkesehatan, dan menjual perhiasan/sawah. Kebutuhan pelayanan kesehatan yang diharapkan keluarga penderita talasemia adalah konsultasi talasemia dan desain khusus ruang perawatan anak. Kebutuhan pembiayaan kesehatan keluarga penderita talasemia adalah uang transportasi ke rumah sakit sebagai bentuk biaya tidak langsung.Kata kunci: Ability to pay, need assessment, pembiayaan kesehatan, talasemia, willingness to pay Abstract Health financing of majority thalassemia patients, around 146 people (60%) in Banyumas year 2011 is assured by Households in direct payments to health care providers (out-of-pocket payment). This study aimed to analyze the ability to pay, willingness to pay, and need assessment of health financing thalassemia in Banyumas. This research an analytic observation- Analisis Pembiayaan Kesehatan Keluarga Penderita Talasemia Health Financing Analysis of Thalassemia Patient FamilyArif Kurniawan, Arih Diyaning Intiasari al with case study design. This research used cross sectional approach. Sampling technique used simple random sampling. Total sample of 30 respondents who had had family members suffering from thalassemia in Banyumas. The results showed thalassemia families have an average ability to pay of Rp34,448.8/month and the average willingness to pay for the treatment on thalassemia Rp133,833.3/month. Health financing patterns of thalassemia in Banyumas district uses 93.3% health security, 3.3% personal costs, and 3.3% health insurance. Before getting health security, 90.0% of respondents performed out-of-pocket financing, get loan, skimped on nonmedical needs, and sold jewelry/rice fields to finance thalassemia's health services. Health care needs that expected by thalassemia patient's family is thalassemia consulting and special design of child-care room. Health financing needs of thalassemia's patient family is transportation money to hospital as indirect costs.

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“…One of the main goals of the system is to address catastrophic medical payments [14]. Since the launch of the NRCMS, access to and utilization of medical care among rural residents has improved [8, 15].…”

Section: Introductionmentioning

confidence: 99%

Effects of China’s New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach

Sun

Shen

et al. 2016

BMC Health Serv Res

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BackgroudThis study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in order to examine whether China’s New Rural Cooperative Medical Scheme has alleviated its medical impoverishment and to compare the results of this alternative approach with those of a World Bank approach.MethodsThis cross-sectional study was based on a stratified random sample survey of 1,987 households and 6,135 individuals conducted in 2008 across eight counties in Yanbian Korean Autonomous Prefecture, Jilin province, China. A new approach was developed to define and identify medical impoverishment. The poverty head count ratio, relative poverty gap, and average poverty gap were used to measure medical impoverishment. Changes in medical impoverishment after the reimbursement under the New Rural Cooperative Medical Scheme were also examined.ResultsThe government-run New Rural Cooperative Medical Scheme reduced the number of medically impoverished households by 24.6 %, as well as the relative and average gaps by 37.3 % and 38.9 %, respectively.ConclusionsChina’s New Rural Cooperative Medical Scheme has certain positive but limited effects on alleviating medical impoverishment in rural Yanbian regardless of how medical impoverishment is defined and measured. More governmental and private-sector efforts should therefore be encouraged to further improve the system in terms of financing, operation, and reimbursement policy.

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Effect of household and village characteristics on financial catastrophe and impoverishment due to health care spending in Western and Central Rural China: A multilevel analysis

Cited by 37 publications

References 24 publications

The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

Analisis Pembiayaan Kesehatan Keluarga Penderita Talasemia

Effects of China’s New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach

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