Households Study on Out-of-Pocket Health Expenditures in Pakistan

Khalid, Mahmood; Sattar, Abdul

doi:10.32368/fjes.20161205

Cited by 14 publications

(12 citation statements)

References 8 publications

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“…In Pakistan, OOP expenditures are around 70% of the total healthcare expenditures. Not only are CVDs the most prevalent diseases among South Asian population, but also being a South Asian is considered a risk factor for CVD ( Lozano et al, 2012 ; Khalid and Sattar, 2016 ). In this context, our data suggested that probably many CVD patients, especially living in poverty struck rural areas, had to forego the treatments, considering the extent of unaffordability of CVD medicines observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Access to Essential Cardiovascular Medicines in Pakistan: A National Survey on the Availability, Price, and Affordability, Using WHO/HAI Methodology

Saeed

et al. 2021

Front. Pharmacol.

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Objective: This national survey was aimed at measuring the access to cardiovascular disease (CVD) medicines in terms of their availability, price, and affordability in Pakistan. This was done by using the standard WHO/Health Action International (HAI) methodology.Methods: The price and availability data for 18 CVD medicines were collected from public sector hospitals (n = 40) and private sector retail pharmacies (n = 40) in eight cities of Pakistan. The outcome measures were availability (calculated as percentage of health facilities stocked with listed medicines), medicine price to the international reference price ratio (i.e., median price ratio (MPR)), and affordability (calculated as number of days’ wages (NDWs) of the lowest paid unskilled government worker required to afford one-month treatment of a chronic disease). The affordability of standard treatment in Pakistan with four CVD drugs was compared with data from six other low and middle income countries (LMICs) using HAI database.Findings: The mean percent availability of CVD medicines was significantly low (p < 0.001) in the public sector as compared to the private sector, that is, 25.5% vs. 54.6% for originator brands (OBs) and 30.4% vs. 34.9% for lowest price generics (LPGs), respectively. For all OBs and LPGs, the inflation-adjusted mean MPR was 2.72 and 1, respectively. CVD medicines were found to be unaffordable with average NDWs of 6.4 and 2.2 for OBs and LPGs, respectively, that is, NDWs of more than 1. In international comparison with countries such as Sudan, Lebanon, Egypt, India, Afghanistan, and China, the affordability of standard treatment with selected CVD medicines (atenolol, amlodipine, captopril, and simvastatin) in Pakistan was found to be low. Overall, all four OBs and three out of four LPGs of selected CVD drugs were found unaffordable in Pakistan.Conclusion: This data indicated that the availability of selected CVD medicines was low in both public and private sector medicine outlets. Both OBs and LPGs were found unaffordable in the private sector, necessitating the redressal of pricing policies, structuring, and their implementation.

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Section: Discussionmentioning

confidence: 99%

Access to Essential Cardiovascular Medicines in Pakistan: A National Survey on the Availability, Price, and Affordability, Using WHO/HAI Methodology

Saeed

et al. 2021

Front. Pharmacol.

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“…[2] Public health expenditure to GDP ratio has remained low in developing countries and the general public has no choice but to seek healthcare from their own pocket, which has remained the dominant source of financing. [3] Significant Out of pocket expenditure may lead households to a "financial catastrophe" in the absence of risk and payment pooling mechanisms or insurance. [4] Globally, approximately 44 million households or more than 150 million individuals face cata-strophic health expenditure (CHE), and about 25 million households or more than 100 million individuals are pushed into poverty by the need to pay for services every year.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Pokharel

Acharya

Pahari

et al. 2021

APJHM

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Background: Healthcare financing as a lever to move closer to universal health coverage. Financing health care has been identified as a barrier to access to health care and increases the likelihood of impoverishment of households. There is still limited study and information on healthcare service utilization in the rural community of Nepal. Our study aims to assess utilization of healthcare services & patterns of healthcare expenditure in the rural households of Nepal. Methods: A community-based research study was conducted among 341 rural households of Tanahun District, Nepal. A Chi-square test was used for assessing the associated factors with healthcare utilization. Results: The utilization of in-patient and out-patient health services was 89.9 % and 10.1 % respectively. The majority of households (88%) had in USD less than $410 annual household healthcare expenditure. The mean annual healthcare expenditure was found to be $279. Nearly three-fourths (71.4%) of households had annual expenditure on medicine more than $40 with mostly on allopathic medicine (93.4%). The majority of participants (70%) mentioned that the healthcare expenditure was a burden to their household. Conclusion: Despite the higher knowledge of health insurance, the involvement was found to be very low & poor. Educational status, knowledge about insurance, privileged ethnicity, religion, income source were the major factors associated with the utilization of healthcare services. Awareness & promotion programs focusing on rural communities should be implemented with affordable health services.

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“…17 Health expenditure to gross domestic product (GDP) ratio has always remained low in Pakistan and maintained less than one percent of the total GDP. 18 According to The World Bank, out-ofpocket expenditure (percentage of current health expenditure) is 65.23 %. Another study conducted in Lahore may also be related to our study which showed that most of the patients managed to receive their treatments in public hospitals and none of them was health insured.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the access of oral health care facilities among adults: an exploratory study from Lahore

Akram¹,

Yasmin

Atif

et al. 2020

J Fatima Jinnah Med Univ

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Background: Oral health is one of the key indicators of the quality of life, overall health and well‑being of the general population. Globally, the high prevalence of the periodontal disease, excessive tooth loss, dental caries experiences, oral cancers and xerostomia are the major issues reported among adult populations. Timely access to oral healthcare facilities preserves the function, morbidity and mortality. The best possible health outcomes are only possible if the personal health care services are accessible timely. So, the primary objective of this study was to explore the barriers to the access of oral health care facilities among adults. In addition, the study also determined the association between adult’s demographic factors and their visits to dental clinics. Subjects and methods: This exploratory study was conducted for two months between November 2019 and January 2020. The study recruited 400 adults including 200 males and 200 females visiting outpatient department (OPD) of public hospital i.e. Jinnah Hospital, Lahore. Participants were included in this study if they were 18 years of age or older and had provided written informed consent before data collection. Data were collected using a structured questionnaire whereas barriers to access the oral healthcare facilities was confirmed by asking an open-ended question. Statistical Package for Social Sciences (SPSS) software was used to calculate descriptive statistics (i.e., mean, standard deviation, percentages). The study also determined the association between sociodemographic factors of adults and their tendency to visit dental clinics just for routine checkups using the chi-square test. Results: The average age of the participants was 36.81±9.29 years ranged from 18 – 63 years. Of the 400 participants, 259 (64.75%) reported costly treatment as a barrier affecting access to oral healthcare facilities followed by difficulty in access to dental clinics (27.75%) and fear of the pain of dental procedures (20.25%). Only 52 (13%) adults were regularly visiting dental clinics for routine check-ups whereas 21 (5.25%) respondents never had been to the dentist throughout their life. Nearly, half of the respondents i.e. 189 (47.25%) stated that dental care expenditures were borne by them and none of them was health insured. Statistically, a significant association was found between demographics (i.e. education, rural background and income) and the tendency to visit the dental clinics (p<0.05). Conclusion: Expensive treatment, difficulty in accessing dental facilities and fear from dental procedures are the major barriers to the utilization of dental services. Access to dental clinics for routine check-ups is significantly influenced by sociodemographic factors.

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Households Study on Out-of-Pocket Health Expenditures in Pakistan

Cited by 14 publications

References 8 publications

Access to Essential Cardiovascular Medicines in Pakistan: A National Survey on the Availability, Price, and Affordability, Using WHO/HAI Methodology

Access to Essential Cardiovascular Medicines in Pakistan: A National Survey on the Availability, Price, and Affordability, Using WHO/HAI Methodology

Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal

Barriers to the access of oral health care facilities among adults: an exploratory study from Lahore

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