Financial Protection in Health among the Elderly – A Global Stocktake

Abstract

Universal Health Coverage is one of the key targets of the Sustainable Development Goals and it implies that everyone can access the healthcare they need without suffering financial hardship. In this paper, we use a large set of household surveys to examine if older populations are facing different degrees of financial hardship compared to younger populations. We find that while differences in average age structures between countries are not systematically associated with higher financial risk related to outof-pocket health expenditures, there are large differences in financial hardship between younger and older households within countries. Households with more elderly members are more likely to face catastrophic and impoverishing out-of-pocket health payments compared to younger households, and this age gradient is stronger for the poorest segments of the population. Making progress toward Universal Health Coverage will require extension and improved targeting of benefit packages and financial protection to meet the health needs of older adults, and especially the poorest and most vulnerable segments of elderly populations.

Role of publicly funded health insurance in financial protection of the elderly from hospitalisation expenditure in India-findings from the longitudinal aging study

“…Nations across the world have adopted Universal Health Coverage (UHC) as the desired goal for health systems and ensuring protection from catastrophic health expenditures is central to it. Studies in India and other LLMICs have shown that hospitalisations of the elderly often lead to catastrophic expenditure for the elderly and their families [8,[13][14][15][16][17][18]. The occurrence of large OOPE on hospitalisations of the elderly poses a significant challenge to India's aim of achieving UHC, [8,11,19].…”

Global Monitoring Report on Financial Protection in Health 2021

“…Using a different approach to compare incidence rates of catastrophic health spending among those living in households with different age structures but controlling for other possible confounders (e.g. socioeconomic status), a recent study confirms the large differences in financial hardship between younger and older households across countries, with people living in households with higher old-age dependency ratios facing the highest incidence of catastrophic health spending (34). Most importantly, the study finds that differences in incidence of catastrophic health spending between those living in older households and those living in younger ones is the strongest within the poorest quintile of a given country (Box 4).…”

“…A recent study by Eozenou et al (34) explores the relationship between the incidence of catastrophic and impoverishing health spending and household old-age dependency levels. The study was based on household survey data from 133 countries (representing 89% of the world population).…”

Old‐age dependency and catastrophic health expenditure: Evidence from Longitudinal Ageing Study in India

“…To understand the effect of old age members on household CHE, we derived a household measure, the Old-Age Dependency Ratio (OADR), defined as the ratio of old-age dependents (60 years and above) to members in the working-age (18-60 years). 24,32…”

“…2,31 The present study used the household old-age dependency approach to capture the effect of old-age members on household CHE. 32 Second, we used the capacity-to-pay approach for estimating CHE and estimated concentration curve as it addresses equity consideration. We also plotted a CHE curve across old-age dependency households as recommended in literature.…”