Trends in out of pocket payments and catastrophic health expenditure in the Kyrgyz Republic post “Manas Taalimi” and “Den Sooluk” health reforms, 2012–2018

Iamshchikova, Mariia; Mogilevskii, Roman; Onah, Michael Nnachebe

doi:10.1186/s12939-020-01358-2

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…This might be due to the fact that single individuals do not have either spouse or family members to support financially for healthcare, or because single people tend to be physically and mentally less healthy due to less social support from the spouse and family, thus increasing their expenditures for health. This result is in line with studies which showed single unmarried respondents have higher CHE (25,(32)(33)(34) and different from studies which showed married households were more likely to incur CHE (35)(36)(37).…”

Section: Discussionsupporting

confidence: 81%

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

Wan Puteh,

Abdullah,

Aizuddin

2024

MJMHS

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Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.

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Section: Discussionsupporting

confidence: 81%

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

Wan Puteh,

Abdullah,

Aizuddin

2024

MJMHS

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Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature

Rahman

Gasbarro

Alam

2022

Health Res Policy Sys

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Background Financial risk protection (FRP), defined as households’ access to needed healthcare services without experiencing undue financial hardship, is a critical health systems target, particularly in low- and middle-income countries (LMICs). Given the remarkable growth in FRP literature in recent times, we conducted a scoping review of the literature on FRP from out-of-pocket (OOP) health spending in LMICs. The objective was to review current knowledge, identify evidence gaps and propose future research directions. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to conduct this scoping review. We systematically searched PubMed, Scopus, ProQuest and Web of Science in July 2021 for literature published since 1 January 2015. We included empirical studies that used nationally representative data from household surveys to measure the incidence of at least one of the following indicators: catastrophic health expenditure (CHE), impoverishment, adoption of strategies to cope with OOP expenses, and forgone care for financial reasons. Our review covered 155 studies and analysed the geographical focus, data sources, methods and analytical rigour of the studies. We also examined the level of FRP by disease categories (all diseases, chronic illnesses, communicable diseases) and the effect of health insurance on FRP. Results The extant literature primarily focused on India and China as research settings. Notably, no FRP study was available on chronic illness in any low-income country (LIC) or on communicable diseases in an upper-middle-income country (UMIC). Only one study comprehensively measured FRP by examining all four indicators. Most studies assessed (lack of) FRP as CHE incidence alone (37.4%) or as CHE and impoverishment incidence (39.4%). However, the LMIC literature did not incorporate the recent methodological advances to measure CHE and impoverishment that address the limitations of conventional methods. There were also gaps in utilizing available panel data to determine the length of the lack of FRP (e.g. duration of poverty caused by OOP expenses). The current estimates of FRP varied substantially among the LMICs, with some of the poorest countries in the world experiencing similar or even lower rates of CHE and impoverishment compared with the UMICs. Also, health insurance in LMICs did not consistently offer a higher degree of FRP. Conclusion The literature to date is unable to provide a reliable representation of the actual level of protection enjoyed by the LMIC population because of the lack of comprehensive measurement of FRP indicators coupled with the use of dated methodologies. Future research in LMICs should address the shortcomings identified in this review.

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The burden of catastrophic and impoverishing health expenditure in Armenia: An analysis of Integrated Living Conditions Surveys, 2014–2018

Kazungu

Meyer²,

Sargsyan³

et al. 2022

PLOS Glob Public Health

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Armenia’s health spending is characterized by low public spending and high out-of-pocket expenditure (OOP), which not only poses a financial barrier to accessing healthcare for Armenians but can also impoverish them. We analyzed Armenia’s Integrated Living Conditions Surveys 2014–2018 data to assess the incidence and correlates of catastrophic health expenditure (CHE) and impoverishment. Households were considered to have incurred CHE if their annual OOP exceeded 40 percent of the per capita annual household non-food expenditure. We assessed impoverishment using the US$1.90 per person per-day international poverty line and the US$5.50 per person per-day upper-middle-income country poverty line. Logistic regression models were fitted to assess the correlates of CHE and impoverishment. We found that the incidence of CHE peaked in 2017 before declining in 2018. Impoverishment decreased until 2017 before rising in 2018. After adjusting for sociodemographic factors, households were more likely to incur CHE if the household head was older than 34 years, located in urban areas, had at least one disabled member, and had at least one member with hypertension. Households with at least one hypertensive member or who resided in urban areas were more likely to be impoverished due to OOP. Paid employment and high socioeconomic status were protective against both CHE and impoverishment from OOP. This detailed analysis offers a nuanced insight into the trends in Armenia’s financial risk protection against catastrophic and impoverishing health expenditures, and the groups predominantly affected. The incidence of CHE and impoverishment in Armenia remains high with a higher incidence among vulnerable groups, including those living with chronic disease, disability, and the unemployed. Armenia should consider different mechanisms such as subsidizing medication and hospitalization costs for the poorest to alleviate the burden of OOP.

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Trends in out of pocket payments and catastrophic health expenditure in the Kyrgyz Republic post “Manas Taalimi” and “Den Sooluk” health reforms, 2012–2018

Cited by 3 publications

References 31 publications

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature

The burden of catastrophic and impoverishing health expenditure in Armenia: An analysis of Integrated Living Conditions Surveys, 2014–2018

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