CATA Meets IMPOV : A Unified Approach to Measuring Financial Protection in Health

Wagstaff, Adam ; Eozenou, Patrick Hoang-Vu

World Bank, Washington, DC

关键词: ABILITY TO PAY;    AGRICULTURAL GROWTH;    CALORIE INTAKE;    CALORIES PER PERSON;    CONSUMER PRICE INDEX;   

DOI  :  10.1596/1813-9450-6861
RP-ID  :  WPS6861

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Up to now catastrophic and impoverishingpayments have been seen as two alternative approaches tomeasuring financial protection in health. Building on theprevious literature, the authors propose a unifiedmethodology in which impoverishing and catastrophic paymentsare mutually exclusive outcomes. They achieve this byexpressing out-of-pocket payments as a ratio of'discretionary' consumption, defined as the amountby which total consumption (gross of out-of-pocket payments)exceeds the poverty line. This allows the authors toidentify both households who are impoverished byout-of-pocket payments (their ratio exceeds one) andhouseholds who are pushed even further into poverty byout-of-pocket payments (their ratio is negative); theauthors call such payments 'immiserizing'.Households experiencing 'catastrophic' paymentsare a subset of those who incur out-of-pocket payments butwho are neither impoverished nor immiserized by them. Twoalternative definitions of catastrophic payments areoffered: those that absorb more than a pre-specifiedfraction of discretionary consumption; and those that leavea household's nonmedical consumption (total consumptionnet of out-of-pocket spending) below a pre-specifiedmultiple of the poverty line. The authors also offer asimple financial protection index that reflects thepercentages of households incurring immiserizing,impoverishing, catastrophic, non-catastrophic, and zeroout-of-pocket payments. They illustrate their unifiedapproach with data from the World Health Survey, usinginternational poverty lines and a catastrophic paymentthreshold of 40 percent.