Inputs for universal health coverage: a methodological contribution to finding proxy indicators for financial hardship due to health expenditure

BMC Health Services Research

Fabrizio Tediosi²  Thomas Smith¹  Priyanka Saksena¹ 

[1] Swiss Tropical and Public Health Institute, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland;Centre for Research on Health and Social Care Management (CERGAS), Università Bocconi, Milan, Italy

关键词: Health expenditure;    Health payments;    Out-of-pocket payments;    Impoverishment;    Catastrophic health expenditure;    Financial risk protection;    Financial burden;    Financial hardship;    Universal health coverage;   

Others  :  1091037
DOI  :  10.1186/s12913-014-0577-2

 received in 2014-08-27, accepted in 2014-11-03,  发布年份 2014

【 摘 要 】

Background

Universal health coverage is high on national health agendas of many countries at the moment. Absence of financial hardship is a key component of universal health coverage and should be monitored regularly. However, relevant household survey data, which is traditionally needed for this analysis is not frequently collected in most countries and in some countries, has not been collected at all. As such, proxy indicators for financial hardship would be very useful.

Methods

We use data from the World Health Survey and use multi-level modeling with national and household level characteristics to see which indicators have a consistent and robust relationship with financial hardship. To strengthen the validity of our findings, we also use different measures of financial hardship.

Results

There are several household level characteristics that seem to have a consistent relationship with financial hardship. However there is only one strong candidate for a proxy indicator at the national level– the share of out-of-pocket payments in total health expenditure. Additionally, the Gini coefficient of total household expenditure was also correlated to financial hardship in most of our models.

Conclusion

The national level indicators related only weakly to the risk of financial hardship. Hence, there should not be an over-reliance on them and collecting good quality household survey data is still a superior option for monitoring financial hardship.

【 授权许可】

   
2014 Saksena et al.; licensee BioMed Central Ltd.

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