Out-of-Pocket Expenditures on Health : A Global Stocktake
This paper provides an overview of research on out-of-pocket health expenditures, reviewing the various summary measures and the results of multi-country studies using these measures. The paper presents estimates for 146 countries from all World Ba...
| Main Authors: | , , |
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| Format: | Working Paper |
| Language: | English |
| Published: |
World Bank, Washington, DC
2019
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/404051554751713745/Out-of-Pocket-Expenditures-on-Health-A-Global-Stocktake http://hdl.handle.net/10986/31537 |
| Summary: | This paper provides an overview of
research on out-of-pocket health expenditures, reviewing the
various summary measures and the results of multi-country
studies using these measures. The paper presents estimates
for 146 countries from all World Bank income groups for all
summary measures, along with correlations between the
summary measures and macroeconomic and health system
indicators. Large differences emerge across countries in per
capita out-of-pocket expenditures in 2011 international
dollars, driven in large part by differences in per capita
income and the share of gross domestic product spent on
health. The two measures of dispersion or risk -- the
coefficient of variation and Q90/Q50 -- are only weakly
correlated across countries and not explained by the
macroeconomic and health system indicators. Considerable
variation emerges in the out-of-pocket health expenditure
budget share, which is highly correlated with the incidence
of "catastrophic" expenditures. Out-of-pocket
expenditures tend to be regressive and catastrophic
expenditures tend to be concentrated among the poor when
expenditures are assessed relative to income, while
expenditures tend to be progressive and catastrophic
expenditures tend to be concentrated among the rich when
expenditures are assessed relative to consumption. At the
extreme poverty line of $1.90-a-day, most impoverishment due
to out-of-pocket expenditures occurs among low-income countries. |
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