Progressivity and horizontal equity in health care finance and delivery: What about Africa?

Cisse, Boubou; Luchini, Stéphane; Moatti, Jean Paul

doi:10.1016/j.healthpol.2006.02.011

Cited by 63 publications

(52 citation statements)

References 44 publications

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“…However, richer quintile groups were found to pay less as a percentage of their total consumption expenditure, consistent with the findings in other studies of Vietnam [51,52]. This mirrors broader concerns about inequity in health care financing in low-income countries that have been extensively discussed in the literature [53] [30] [54].…”

Section: Discussionsupporting

confidence: 87%

Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

Ali

Cookson

Dusheiko

2017

Social Science & Medicine

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Section: Discussionsupporting

confidence: 87%

Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

Ali

Cookson

Dusheiko

2017

Social Science & Medicine

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“…In addition, N shows the sample size of each year (21)(22)(23)(24)(25). Calculating Z, there would be four possible situations.…”

Section: Dominance Test (T-test)mentioning

confidence: 99%

Equity in Health Care Financing Among Iranian Households

et al. 2015

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Background: One of the main challenges of all health systems is achieving equity in healthcare financing. The Kakwani index is an equity index used to show how distant a financing source is from the proportional status. Objectives: The present study aimed to measure the equity of Iran's health system financing in rural and urban areas between 2001 and 2010 using the Kakwani index. Materials and Methods: This study analyzed secondary data for the years 2001 through 2010 in Iran. The data of annual household expenditures and an income survey conducted by the statistical center of Iran (SCI) were used in this study. In addition, out of pocket payments and health insurance premiums, as two sources of healthcare financing, were investigated regarding vertical equity. The T-test was used to test the dominance of the curves. Results: The Kakwani index was negative (regressive) for out of pocket payments among both rural and urban households (-0.168 in 2001 to -0.197 . The dominance test (T-test) showed the concentration curves of out of pocket payments in both areas dominated the Lorenz curve in all years, but the dominance test (T-test) for health insurance premium payments did not follow a regular trend during the study period. Conclusions: Due to the negativity of the Kakwani index for out-of-pocket payments, a great burden on the households can be predicted, and the progressivity of health insurance premium payments implies that expanding insurance coverage may lead to more equitable financing. Thus, the government should take the responsibility to expand the service and cost coverage of insurance plans and to develop policies that protect poor people.

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“…The indirect need-standardization based horizontal inequity (HI) index (Wagstaff and Van Doorslaer 2000b) is a convenient measurement tool for the evaluation of inequity in health care utilization. Together with the CI, it has been applied extensively to international or intertemporal comparisons on inequality and inequity in the delivery of health care (for example, Cisse et al 2007;Hernandez-Quevedoa et al 2006;Lu et al 2007;Van Doorslaer et al 2004a,b,c;Zere and McIntyre 2003;etc. ).…”

Section: Introductionmentioning

confidence: 99%

On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?

Zhong

2010

Int J Health Care Finance Econ

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Health care financing arrangements not only have strong implications for income distribution, but also affect health care utilization. Therefore, a comparison of the equity in health care utilization for those health systems with different financing arrangements has important policy implications for health care policymakers. The concentration index (CI) and the horizontal inequity index (HI) are commonly used to measure inequality and inequity in health care utilization. In this paper, we propose simple methods to decompose the difference between two CIs and two HIs into two factors: one factor reflects the difference between the means, and the other factor reflects the difference between the distributions. The proposed decomposition method might be useful since the means are likely to be caused by factors that do not constitute unfair inequalities (inequities). We also present two empirical applications of the decomposition methods for the purpose of illustration.

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Progressivity and horizontal equity in health care finance and delivery: What about Africa?

Cited by 63 publications

References 44 publications

Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

Equity in Health Care Financing Among Iranian Households

On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?

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