Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan

International Journal for Equity in Health

Shah Iqbal Azam Syed¹  Ashar Muhammad Malik² 

[1] Community Health Sciences Department, Aga Khan University, Karachi, Pakistan;Community Health Sciences Department, Aga Khan University, Stadium Road, Karachi, 78400, Pakistan

关键词: Pakistan;    Developing countries;    Health policy;    Demand for health;    Healthcare financing;    Equity;    Social and economic determinants;    Out-Of-Pocket payment;   

Others  :  826251
DOI  :  10.1186/1475-9276-11-51

 received in 2012-04-16, accepted in 2012-08-27,  发布年份 2012

【 摘 要 】

Background

Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap.

Methods

We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a multiple regression model for the determinants of OOP payments using methods of Ordinary Least Square (OLS). We mainly used social, economic, demographic and health variables in our analysis.

Results

Median household OOP healthcare in the year 2004-05 was Pakistani Rupees (PKR) 2500 (US$ 41.99) in 2004-05. Household non-food expenditure was the single highest significant predictor of household OOP health expenditure. Household features like literate head and spouse, at least one obstetric delivery in last three years, unsafe water, unhygienic toilet and household belonging to Khyber Pukhtonkhwa (KPK) province were significant positive predictors of OOP payments. Households with male head, bricks used in housing construction, household with at least one child and no elderly, and head of household in a white collar profession were negative predictors of OOP payments.

Conclusion

Our analysis confirms earlier findings that economic status and number of old aged members are significant positive predictors of OOP payments. This association can direct government to enhance allocations to healthcare and to include program focusing on non-communicable diseases. Our findings suggest further research to explore beneficiaries of government healthcare programs and determinants of high OOP payments by household residing in KPK province than other province. The interaction between white collar profession and their economic status in predicting OOP payments is also an area for further research.

【 授权许可】

   
2012 Muhammad Malik and Azam Syed; licensee BioMed Central Ltd.

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