Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance

Li, Ye; Wu, Qunhong; Xu, Lei; Legge, David; Hao, Yanhua; Gao, Lijun; Ning, Ning; Wu, Gang

doi:10.2471/blt.12.102178

Cited by 368 publications

(493 citation statements)

References 15 publications

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“…One of these decisions is to purchase health insurance coverage (or to exert political pressure by voting for a party that promises to introduce social health insurance for everyone; even the Chinese regime had to expand health insurance coverage beyond urban workers, as mentioned in [3]). However, going without health insurance can be perfectly rational.…”

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confidence: 99%

“…The WHO followed up by publishing a brief on how to design the financing of health care to reduce cHCE [5]. Meanwhile, the cHCE concept has even reached China, with the suggestion that copayments should also be covered by insurance, as though moral hazard simply did not exist in that country [3]. The conclusion for policy in [6] has not changed over the years: ''In the long term, the aim should be to develop prepayment mechanisms, such as through social health insurance, tax-based financing of health care, or some mix of prepayment mechanisms''.…”

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confidence: 99%

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‘Catastrophic’ healthcare expenditure: critique of a problematic concept and a proposal

Zweifel

2016

Eur J Health Econ

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mentioning

confidence: 99%

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confidence: 99%

‘Catastrophic’ healthcare expenditure: critique of a problematic concept and a proposal

Zweifel

2016

Eur J Health Econ

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“…26,27 Calculating the Catastrophic Healthcare Expenditures CHE is important to measure equity in health financing. Households with healthcare expenditures higher than 40% of their capacity to pay were grouped under those households facing catastrophic healthcare expenditures.…”

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confidence: 99%

Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

Piroozi¹,

Moradi²,

Nouri³

et al. 2016

Int J Health Policy Manag

108

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Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results:The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion:The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against CHE.

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“…Extent of catastrophic OOP expense using different thresholds and methodologies is well documented. It was 6-15% in Nouna district, 2 16-51% on maternity care, 3 2.8% (in 1999) and 11.7% (in 2007) in Georgia, 4 0.6% in Turkey, 5 14.8% in Nigeria, 6 13-22.2% in China, 1,7 13.8% in Nepal, 8 0.7-21.0% in Brazil, 9 9.6% in Colombo, 10 3.5-4.8% in Iran 11,12 with Catastrophic health expenditure headcount ratio of more than 2% in Iran. 13 Above data is important to measure long-term impacts of the policy interventions in different geographic locations using uniform methods at each location.…”

Section: Introductionmentioning

confidence: 99%

“…[16][17][18] Studies indicate that expenses on indoor hospitalizations are catastrophic especially for poor. 4,7,10,17,19 Some researchers have documented the catastrophic expenses in specific disease conditions. The relationship between chronic diseases and their financial burden on households is double-sided, as financial difficulties can give rise to, and result from, chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Catastrophic Expense & Financial Protection Mechanisms to Achieve Universal Health Coverage: A Review

Aggarwal¹

2017

MOJPH

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Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance

Cited by 368 publications

References 15 publications

‘Catastrophic’ healthcare expenditure: critique of a problematic concept and a proposal

‘Catastrophic’ healthcare expenditure: critique of a problematic concept and a proposal

Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

Catastrophic Expense & Financial Protection Mechanisms to Achieve Universal Health Coverage: A Review

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