Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis

Sarker, Abdur Razzaque; Sultana, Marufa; Alam, Khorshed; Ali, Nizar Bel Hadj; Sheikh, Nurnabi; Akram, Raisul; Morton, Alec

doi:10.1002/hpm.3275

Cited by 14 publications

(18 citation statements)

References 49 publications

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“…Arcaya et al systematically reviewed the methodological, theoretical, and philosophical aspects of health inequalities, which provides scientific guidance for the study of health ( 11 ). To better assess the equity of healthcare service, a series of indicators, such as the Kakwani index ( 12 , 13 ), the concentration index (CI) ( 14 , 15 ), and the horizontal inequity (HI) ( 16 , 17 ), are introduced to measure inequity in healthcare resource utilization and determine the contribution of different influences to the overall unfairness. Moreover, machine learning techniques are increasingly used to optimize health and social systems to ensure equality in healthcare delivery outcomes, performance, and resource allocation ( 18 , 19 ).…”

Section: Literature Reviewmentioning

confidence: 99%

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

2022

Front. Public Health

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The equalization of healthcare supply is not only related to the people's need for a better life, but can also provide a strong guarantee for the high-quality and sustainable development of the Yangtze River Delta integration. By using exploratory spatial analysis techniques, this study analyzed the spatio-temporal evolution characteristics and heterogeneous influence effects of the supply level of healthcare service in the Yangtze River Delta from 2007 to 2019. It was found that the supply level of healthcare service in the Yangtze River Delta had improved significantly. The differences in the supply level of healthcare service between cities had tended to narrow without polarization, and the supply level of healthcare service generally showed a high spatial pattern in the south delta and low spatial pattern in the north delta. The higher the supply level of healthcare service was, the weaker the interannual variability was. The supply level of healthcare service in the Yangtze River Delta region presented obvious spatial association and differentiated tendency of local high and low spatial clusters. The relative length and curvature of the supply level of healthcare service in the Yangtze River Delta generally presented a spatial pattern with low values in the northeast and high values in the southwest. Population density and urban-rural income gap generally exhibited negative spatio-temporal impact on the supply level of healthcare service across most cities. On the other hand, urbanization level and per capita disposable income generally had positive spatio-temporal impact on the supply level of healthcare service across most cities. Per capita gross domestic product (GDP) showed an increasingly positive spatio-temporal impact on the supply level of healthcare service across most cities. While per capita fiscal expenditure exhibited significantly negative impact on the supply level of healthcare service across most cities in space.

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Section: Literature Reviewmentioning

confidence: 99%

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

2022

Front. Public Health

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“…73 OOPE is the most important component of health care financing in many countries and a leading cause of impoverishment. [74][75][76] A high OOPE on health care increases the financial load of households and pushes them deeper into poverty. 15,77,78 OOPE includes expenses on medicines, transportation, stay, meal, paperwork, etc.…”

Section: Out-of-pocket Expenditurementioning

confidence: 99%

“…Achieving Universal health coverage requires careful monitoring of out‐of‐pocket expenditure (OOPE) 73 . OOPE is the most important component of health care financing in many countries and a leading cause of impoverishment 74–76 . A high OOPE on health care increases the financial load of households and pushes them deeper into poverty 15,77,78 .…”

Section: Literature Reviewmentioning

confidence: 99%

A public‐private partnership based model for regulating out‐of‐pocket expenditures to strengthen primary care system

Kumar

2022

Health Planning & Management

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In developing countries like India, the cost of health care is largely borne by patient out‐of‐pocket payments. Recent studies have reported that patients skip public‐funded clinics providing free consultation for distant private care providers. Some of the reasons identified for such behaviour include longer waiting times, perception regarding quality of care, etc. Therefore, optimal allocation of existing and new capacity is critical for a greater public interest. This article presents a decision‐making framework towards this intent for strengthening the existing government primary healthcare network. In this article, a mixed‐integer linear programing (MILP) model is developed for optimal reconfiguration of the existing government primary healthcare network to minimise patient out‐of‐pocket expenditures (OOPE). The model involves three types of facilities: Primary Health Centre (PHC), Community Health Centre (CHC), and Private OPD (outpatient department). Implementation of the proposed model can help in reducing out‐of‐pocket expenditures. The optimization model proposed in the article is unique as it incorporates for the first time, patient out‐of‐pocket expenditure, capacity reconfiguration, and public‐private partnership decisions in the primary healthcare system. A solution algorithm is also proposed for the optimization model. The model would be useful for theory development and also in policy‐making.

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“…Such consequences of OOPE often induce intractable stress on the household's economic security. 3,4 This has narrated the policymakers to implement various financial protective interventions, at national and subnational levels to curb the despicable repercussions of OOPE. 5,6 Health policy researchers have evaluated the effectiveness of such interventional strategies, sans space and time.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of interventions to contain out‐of‐pocket‐expenditure in lower‐middle income countries: A systematic review and synthesis

Sugunan

Pillai

George

2023

Health Planning & Management

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The extant literature on myriad interventional strategies to contain the adverse financial impacts of soaring out‐of‐pocket expenditures commands systematic auditing and knowledge synthesis. The purpose of this study is to answer these specific questions. What are the interventions present in lower‐middle‐income countries? How effective are those interventions in reducing the household's out‐of‐pocket expenditure? Are the studies suffering from any methodological bias? The imprints for this systematic review are obtained from Scopus, PubMed, Web of Science, ProQuest and CINAHL. These manuscripts are identified in full compliance with PRISMA guidelines. The documents identified have undergone quality assessment checks using the ‘Effective Public Health Practice Project’. The review identified Interventions that are found to reduce out‐of‐pocket expenditure are patient educational programs, a combination of financial assistance, healthcare facility quality upgrade measures, and early disease detection strategies. However, these reductions represented marginal changes in the total health expenditure of patients. The role of non‐health insurance interventions and the combination of health insurance and non‐health insurance measures are highlighted. This review concludes by emphasising the need for further research to fill the knowledge gap by building on the suggestions put forward.

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Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis

Cited by 14 publications

References 49 publications

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

A public‐private partnership based model for regulating out‐of‐pocket expenditures to strengthen primary care system

Effectiveness of interventions to contain out‐of‐pocket‐expenditure in lower‐middle income countries: A systematic review and synthesis

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