Examining the density in out-of-pocket spending share in the estimation of catastrophic health expenditures

Abdulrahman Jbaily*, Annie Haakenstad, Mizan Kiros, CJ (Carlos) Riumallo Herl, Stéphane Verguet

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Universal health coverage (UHC) aims to provide access to health services for all without financial hardship. Moving toward UHC while ensuring financial risk protection (FRP) from out-of-pocket (OOP) health expenditures is a critical objective of the Sustainable Development Goal for Health. In tracking country progress toward UHC, analysts and policymakers usually report on two summary indicators of lack of FRP: the prevalence of catastrophic health expenditures (CHE) and the prevalence of impoverishing health expenditures. In this paper, we build on the CHE indicator: we examine the distribution (density) of health OOP budget share as a way to capture both the magnitude and dispersion in the ratio of households’ OOP health expenditures relative to consumption or income at the population level. We illustrate our approach with country-specific examples using data from the World Health Organization’s World Health Surveys.

Original languageEnglish
Pages (from-to)903-912
Number of pages10
JournalEuropean Journal of Health Economics
Volume23
Issue number5
Early online date6 Aug 2021
DOIs
Publication statusPublished - 6 Aug 2021

Bibliographical note

Funding Information:
We thank the Bill & Melinda Gates Foundation for partial funding (INV-1010174). Earlier versions of this paper were presented during seminars at the Harvard T.H. Chan School of Public Health and the meeting of the international Health Economics Association (Basel, July 2019) where we received valuable comments from participants. We also thank two anonymous referees for helpful reviews.

Funding Information:
We thank the Bill & Melinda Gates Foundation for partial funding (INV-1010174). Earlier versions of this paper were presented during seminars at the Harvard T.H. Chan School of Public Health and the meeting of the international Health Economics Association (Basel, July 2019) where we received valuable comments from participants. We also thank two anonymous referees for helpful reviews.

Publisher Copyright:
© 2021, The Author(s).

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