Out-of-pocket nonmedical expenses associated with out-patient treatment of common childhood illnesses

Daga, S. R.; Mhatre, Sameer; Dsouza, Eric

doi:10.1093/tropej/fmv014

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…Our findings are consistent with the results of other studies reporting that the risk of catastrophic health expenditures was strongly associated with the type of hospitals that patients have access to utilization of healthcare [29]. Our results are consistent with similar findings from another study that showed that the burden of OOP payments was highest among the poor [30], but a high incidence of catastrophic health expenditures has also been found among poor income households [31]. This may reflect the severity of disease in the poor (low-income) groups, which may be greater than in the high-income groups.…”

Section: Discussionsupporting

confidence: 93%

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Mahumud

Sarker

Sultana

et al. 2017

J Prev Med Public Health

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ObjectivesAs in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh.MethodsA total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method.ResultsThe mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures.ConclusionsThe findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

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Section: Discussionsupporting

confidence: 93%

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Mahumud

Sarker

Sultana

et al. 2017

J Prev Med Public Health

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“…Thus, to minimize the patients' expenses, Family Health Strategie must prioritize preparing clearer healthcare protocols by defining referral flows, so to meet health demands in a resolute, equitable, and universal strategy. Considering our research backdrop and that food-related direct non-medical costs have been previously reported by other authors 16,17,18 , the public policies should acknowledge our findings, as food is a refundable cost 17 .…”

Section: Discussionsupporting

confidence: 57%

Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

et al. 2020

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Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients’ transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.

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“…conducted a facility based cross-sectional study among children <6 years of age attending the pediatric Outpatient Department (OPD) of a rural nongovernmental medical college in Maharashtra and reported that 36% of the OPD attendance was for respiratory complaints which are higher than that reported in our study. [ 9 ] The different study settings may be a reason for this difference.…”

Section: Discussionmentioning

confidence: 99%

“…61-220), which is lower than our study. [ 9 ] This may be because the medical college provided free OPD services though it was a nongovernmental facility. Therefore, OOP was composed of travel and food charges alone.…”

Section: Discussionmentioning

confidence: 99%

Morbidity profile and out of pocket health care expenditure among under five children of an urban area of Puducherry

Nair¹,

Kar²,

Selvaraj³

et al. 2015

J Nat Sc Biol Med

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Background:Information on out of pocket (OOP) health care expenditure is essential for health planning and devising strategies for Universal Health Coverage (UHC).Aims and objectives:To describe morbidity profile, treatment preferences and OOP expenditure toward health care of under five children in an urban primary health center of Puducherry.Materials and Methods:A cross-sectional study was conducted in four Anganwadi centers selected randomly from a total of 13 centers in the urban service area of JIPMER, Puducherry. All mothers of under five children from selected centers were interviewed regarding sociodemographic details, treatment preferences, and expenditure incurred on illness of under five children by the family for a period of 15 days and 3 months (exclusive of past 15 days) preceding the day of interview.Results:Among the 164 children studied, 23.8% and 30% reported illnesses in the past 15 days and 3 months, respectively. Most frequent illness reported was respiratory infections. Private facilities (60%) were the preferred sources for seeking health care. Median OOP expenditure in last 15 days was Rs. 375 and Rs. 450 for the past 3 months, amounting to 8% and 6.8% of the total family income, respectively. The majority of the health care expenditure was toward drugs (71%). No money was spent toward healthcare in government facilities.Conclusion:Almost all OOP health care expenditure was incurred when the illnesses were managed by private providers. Hence, strategies can be planned to include private providers under UHC.

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Out-of-pocket nonmedical expenses associated with out-patient treatment of common childhood illnesses

Abstract: Families in rural India have substantial costs incurred in OPD attendance, most of which is for preventive health care such as immunization.

Cited by 6 publications

References 5 publications

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

Morbidity profile and out of pocket health care expenditure among under five children of an urban area of Puducherry

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