Author
Deni Harbianto
Bio: Deni Harbianto is an academic researcher from Gadjah Mada University. The author has contributed to research in topics: Health care & Standard of living. The author has an hindex of 7, co-authored 9 publications receiving 1702 citations.
Papers
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TL;DR: The overall prevalence of absolute poverty in these countries was 14% higher than conventional estimates that do not take account of out-of-pocket payments for health care, and policies to reduce the number of Asians living on less than 1 dollar per day need to include measures to reduce such payments.
682 citations
TL;DR: This work estimates the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population and focuses on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources.
Abstract: Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources. Bangladesh, China, India, Nepal and Vietnam rely most heavily on OOP financing and have the highest incidence of catastrophic payments. Sri Lanka, Thailand and Malaysia stand out as low to middle income countries that have constrained both the OOP share of health financing and the catastrophic impact of direct payments. In most low/middle-income countries, the better-off are more likely to spend a large fraction of total household resources on health care. This may reflect the inability of the poorest of the poor to divert resources from other basic needs and possibly the protection of the poor from user charges offered in some countries. But in China, Kyrgyz and Vietnam, where there are no exemptions of the poor from charges, they are as, or even more, likely to incur catastrophic payments.
561 citations
TL;DR: This work estimates the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population and finds that in most low-/middle-income countries, the better-off not only pay more, they also get more health care.
304 citations
TL;DR: The experiences of Malaysia, Sri Lanka, and Thailand suggest that increasing the incidence of propoor healthcare requires limiting the use of user fees, or protecting the poor effectively from them, and building a wide network of health facilities.
Abstract: This article compares the incidence of public healthcare across eleven Asian countries and provinces, testing the dominance of healthcare concentration curves against an equal distribution and Lorenz curves and across countries. The analysis reveals that the distribution of public healthcare is prorich in most developing countries. That distribution is avoidable, but a propoor incidence is easier to realize at higher national incomes. The experiences of Malaysia, Sri Lanka, and Thailand suggest that increasing the incidence of propoor healthcare requires limiting the use of user fees, or protecting the poor effectively from them, and building a wide network of health facilities. Economic growth may not only relax the government budget constraint on propoor policies but also increase propoor incidence indirectly by raising richer individuals' demand for private sector alternatives.
203 citations
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TL;DR: The use of concentration indices and a high degree of consistency in the application of methods provide results that, unlike much of the existing evidence, are comparable across countries.
Abstract: In this paper the benefit incidence of public health care subsidies in eleven Asian territories, including India, Indonesia and two provinces of China is examined. The use of concentration indices and a high degree of consistency in the application of methods provide results that, unlike much of the existing evidence, are comparable across countries.[Working Paper No.3]
31 citations
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TL;DR: The Commission on Social Determinants of Health (CSDH) as mentioned in this paper was created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it.
7,335 citations
Harvard University1, Boston Children's Hospital2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Partners In Health9, Brigham and Women's Hospital10, Royal North Shore Hospital11, Medical College of Wisconsin12, Monash University13, Nanyang Technological University14, University of Sierra Leone15, University of Oxford16, Mongolian National University17, Flinders University18, University of Malawi19, Beth Israel Deaconess Medical Center20, Bhabha Atomic Research Centre21, Royal Australasian College of Surgeons22, Stanford University23, University of California, San Francisco24
TL;DR: The need for surgical services in low- and middleincome countries will continue to rise substantially from now until 2030, with a large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs.
2,209 citations
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TL;DR: In this paper, the authors provide a step-by-step practical guide to the measurement of a variety of aspects of health equity, including gaps in health outcomes between the poor and the better-off in specific countries or in the developing world as a whole.
Abstract: This book shows how to implement a variety of analytic tools that allow health equity - along different dimensions and in different spheres - to be quantified. Questions that the techniques can help provide answers for include the following: Have gaps in health outcomes between the poor and the better-off grown in specific countries or in the developing world as a whole? Are they larger in one country than in another? Are health sector subsidies more equally distributed in some countries than in others? Is health care utilization equitably distributed in the sense that people in equal need receive similar amounts of health care irrespective of their income? Are health care payments more progressive in one health care financing system than in another? What are catastrophic payments? How can they be measured? How far do health care payments impoverish households? This volume has a simple aim: to provide researchers and analysts with a step-by-step practical guide to the measurement of a variety of aspects of health equity. Each chapter includes worked examples and computer code. The authors hope that these guides, and the easy-to-implement computer routines contained in them, will stimulate yet more analysis in the field of health equity, especially in developing countries. They hope this, in turn, will lead to more comprehensive monitoring of trends in health equity, a better understanding of the causes of these inequities, more extensive evaluation of the impacts of development programs on health equity, and more effective policies and programs to reduce inequities in the health sector.
1,301 citations
TL;DR: This work identifies key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India and suggests principles that will help to ensure a more equitable health care for India's population.
798 citations