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...

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Main Authors: Wagstaff, Adam, Eozenou, Patrick, Smitz, Marc
Format: Working Paper
Language:English
Published: World Bank, Washington, DC 2019
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
id okr-10986-31537
recordtype oai_dc
spelling okr-10986-315372022-09-20T00:13:56Z Out-of-Pocket Expenditures on Health : A Global Stocktake Wagstaff, Adam Eozenou, Patrick Smitz, Marc HEALTH EXPENDITURE OUT-OF-POCKET HEALTH COSTS HEALTH AND POVERTY FINANCIAL PROTECTION HEALTH INSURANCE HEALTH FINANCE CATASTROPHE HEALTH EXPENDITURE 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. 2019-04-11T20:52:24Z 2019-04-11T20:52:24Z 2019-04 Working Paper http://documents.worldbank.org/curated/en/404051554751713745/Out-of-Pocket-Expenditures-on-Health-A-Global-Stocktake http://hdl.handle.net/10986/31537 English Policy Research Working Paper;No. 8808 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
topic HEALTH EXPENDITURE
OUT-OF-POCKET HEALTH COSTS
HEALTH AND POVERTY
FINANCIAL PROTECTION
HEALTH INSURANCE
HEALTH FINANCE
CATASTROPHE HEALTH EXPENDITURE
spellingShingle HEALTH EXPENDITURE
OUT-OF-POCKET HEALTH COSTS
HEALTH AND POVERTY
FINANCIAL PROTECTION
HEALTH INSURANCE
HEALTH FINANCE
CATASTROPHE HEALTH EXPENDITURE
Wagstaff, Adam
Eozenou, Patrick
Smitz, Marc
Out-of-Pocket Expenditures on Health : A Global Stocktake
relation Policy Research Working Paper;No. 8808
description 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.
format Working Paper
author Wagstaff, Adam
Eozenou, Patrick
Smitz, Marc
author_facet Wagstaff, Adam
Eozenou, Patrick
Smitz, Marc
author_sort Wagstaff, Adam
title Out-of-Pocket Expenditures on Health : A Global Stocktake
title_short Out-of-Pocket Expenditures on Health : A Global Stocktake
title_full Out-of-Pocket Expenditures on Health : A Global Stocktake
title_fullStr Out-of-Pocket Expenditures on Health : A Global Stocktake
title_full_unstemmed Out-of-Pocket Expenditures on Health : A Global Stocktake
title_sort out-of-pocket expenditures on health : a global stocktake
publisher World Bank, Washington, DC
publishDate 2019
url http://documents.worldbank.org/curated/en/404051554751713745/Out-of-Pocket-Expenditures-on-Health-A-Global-Stocktake
http://hdl.handle.net/10986/31537
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