Catastrophic payments for health care in Asia
Eddy van Doorslaer,Owen O'Donnell,R.P. Rannan-Eliya,Aparnaa Somanathan,Shiva Raj Adhikari,Charu C. Garg,Deni Harbianto,Alejandro N. Herrin,Mohammed N. Huq,Shamsia Ibragimova,Anup Karan,Tae-jin Lee,Gabriel M. Leung,Jui-fen Rachel Lu,Chiu Wan Ng,Badri Raj Pande,Rachel H. Racelis,Sihai Tao,Keith Y.K. Tin,Kanjana Tisayaticom,Laksono Trisnantoro,Chitpranee Vasavid,Yuxin Zhao +22 more
TLDR
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.read more
Citations
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Naoki Ikegami,Byung Kwang Yoo,Byung Kwang Yoo,Hideki Hashimoto,Masatoshi Matsumoto,Hiroya Ogata,Akira Babazono,Ryo Watanabe,Kenji Shibuya,Bong Min Yang,Michael R. Reich,Yasuki Kobayashi +11 more
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Adam Wagstaff,Gabriela Flores,Justine Hsu,Marc-Francois Smitz,Kateryna Chepynoga,Leander R. Buisman,Kim van Wilgenburg,Patrick Eozenou +7 more
TL;DR: The proportion of the population that is supposed to be covered by health insurance schemes or by national or subnational health services is a poor indicator of financial protection and what is required is increasing the share of total health expenditure that is prepaid, particularly through taxes and mandatory contributions.
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Who pays for health care in Asia
Owen O'Donnell,Eddy van Doorslaer,Ravi P. Rannan-Eliya,Aparnaa Somanathan,Shiva Raj Adhikari,Baktygul Akkazieva,Deni Harbianto,Charu C. Garg,Piya Hanvoravongchai,Alejandro N. Herrin,Mohammed N. Huq,Shamsia Ibragimova,Anup Karan,Soonman Kwon,Gabriel M. Leung,Jui-fen Rachel Lu,Yasushi Ohkusa,Badri Raj Pande,Rachel H. Racelis,Keith Y.K. Tin,Kanjana Tisayaticom,Laksono Trisnantoro,Quan Wan,Bong-Min Yang,Yuxin Zhao +24 more
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Jon E. Rohde,Simon Cousens,Mickey Chopra,Viroj Tangcharoensathien,Robert E. Black,Zulfiqar A Bhutta,Joy E Lawn,Joy E Lawn +7 more
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China's Health System and Its Reform : A Review of Recent Studies
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References
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Journal ArticleDOI
Household catastrophic health expenditure: a multicountry analysis.
TL;DR: People, particularly in poor households, can be protected from catastrophic health expenditures by reducing a health system's reliance on out-of-pocket payments and providing more financial risk protection.
Journal ArticleDOI
Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998
TL;DR: Two threshold approaches to measuring the fairness of health care payments are presented, one requiring that payments do not exceed a pre-specified proportion of pre-payment income, the other that they do not drive households into poverty, and the incidence and intensity of 'catastrophe' payments were reduced and became less concentrated among the poor.
Journal ArticleDOI
Insuring Consumption Against Illness
Paul Gertler,Jonathan Gruber +1 more
TL;DR: The authors investigate the extent to which families are able to insure consumption against major illness using a unique panel data set from Indonesia that combines excellent measures of health status with consumption information, and find that there are significant economic costs associated with major illness, and that there is very imperfect insurance of consumption over illness episodes.
Journal ArticleDOI
Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data.
Eddy van Doorslaer,Owen O'Donnell,Ravi P. Rannan-Eliya,Aparnaa Somanathan,Shiva Raj Adhikari,Charu C. Garg,Deni Harbianto,Alejandro N. Herrin,Mohammed N. Huq,Shamsia Ibragimova,Anup Karan,Chiu Wan Ng,Badri Raj Pande,Rachel H. Racelis,Sihai Tao,Keith Y.K. Tin,Kanjana Tisayaticom,Laksono Trisnantoro,Chitpranee Vasavid,Yuxin Zhao +19 more
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.
Journal ArticleDOI
The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome.
TL;DR: It is found that in resource-poor settings illness imposed high and regressive cost burdens on patients and their families, highlighting the urgent need for a substantial increase in health sector investment to expand access to preventive and curative health services.
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