scholarly journals Who Pays More: Public, Private, Both or None? The Effects of Health Insurance Schemes and Health Reforms on Out-of-Pocket and Catastrophic Health Expenditures in Turkey

2016 ◽  
Author(s):  
Eleftherios Giovanis
Keyword(s):  
Health Insurance ◽  
Health Expenditures ◽  
Health Reforms ◽  
Catastrophic Health Expenditures

scholarly journals Catastrophic Health Expenditure before and after of the Implementation of Health Sector Evolution Plan in Iran

2021 ◽  
Vol 58 ◽  
pp. 004695802110502
Author(s):  
Razieh Ahmadi ◽  
Milad Shafiei ◽  
Hosein Ameri ◽  
Roohollah Askari ◽  
Hossein Fallahzadeh
Keyword(s):  
Health Insurance ◽  
Economic Status ◽  
Health Sector ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Financial Protection ◽  
Outpatient Services ◽  
Incremental Change ◽  
Inpatient Services ◽  
Catastrophic Health Expenditures

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods: Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results: The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.

scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

scholarly journals Fear of catastrophic health expenditures and unrealistic expectations from supplementary health insurance: ethnic differences

2018 ◽  
Vol 11 (4) ◽  
pp. 283-289
Author(s):  
Neta HaGani ◽  
Samah Hayek ◽  
Jalal Tarabeia ◽  
Mohammad Yehia ◽  
Manfred S Green
Keyword(s):  
Health Insurance ◽  
Health Expenditures ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accessible Information ◽  
Catastrophic Health Expenditures ◽  
Supplementary Health Insurance ◽  
Universal Health ◽  
Unrealistic Expectations

Abstract Background In Israel, the whole population is covered by comprehensive universal health insurance. Despite that, most of the population purchases supplementary health insurance (SHI). It has been shown that individuals purchase more health insurance and preventive medicine when they are uncertain of their state of health, while a majority may not fully understand basic concepts in their health insurance coverage. The purpose of this study was to examine the role of fear of catastrophic health expenditures and unrealistic expectations in purchasing SHI, which does not cover expenses for life-threatening illnesses. Methods A cross-sectional survey was conducted among random samples of 814 Jews and 800 Arabs in Israel. A structured questionnaire was administered by telephone using random digit dialling. Log-linear regression was used to identify factors associated with reasons for purchasing SHI and expectations from SHI. Results The most common reason for purchasing SHI was fear of catastrophic health-related expenditures (41%). The most important service expected from SHI was ‘cancer medications’ (mean 4.68 [standard deviation 0.87]). Differences in the reasons for purchasing SHI and in expectations from SHI were found according to population group, age, gender and education. Conclusions Consumers’ misconceptions and fear of catastrophic health expenditures are major factors leading to the purchase of SHI, despite universal health coverage. Improved and accessible information should help consumers make informed decisions as to whether or not to purchase SHI.

scholarly journals Can Health Insurance Protect Against Catastrophic Health Expenditures in Iran? A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Moslem Soofi ◽  
Morteza Arab‐Zozani ◽  
Ali Kazemi‐Karyani ◽  
Behzad Karamimatin ◽  
Farid Najafi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Meta Analysis ◽  
Health Expenditures ◽  
Catastrophic Health Expenditures

scholarly journals Who Have a Higher Risk of Falling Into Catastrophic Health Expenditures?

2021 ◽  
Vol 12 (3) ◽  
pp. 217-228
Author(s):  
Amalia Noviani
Keyword(s):  
Health Insurance ◽  
Health Expenditure ◽  
Service Use ◽  
Social Economic ◽  
Outpatient Service ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Economic Factors ◽  
Inpatient Service ◽  
Catastrophic Health Expenditures

Catastrophic health expenditure is one of the challenges Indonesia faces in achieving Universal Health Coverage. Aside from being a financial disaster, the incident caused by out-of-pocket health expenditure exceeding a fixed limit can drive people into poverty. Unfortunately, the availability of the data causes the limitation of the study in Indonesia. This study aims to analyze the association between catastrophic health expenditure and several social-economic factors by using the latest data of out-of-pocket expenditure collected at the individual level from the 2019 Susenas Module of Health and Housing. Using the Chi-square test, this study confirms a significant association between catastrophic health expenditures and the following social-economic factors: outpatient and inpatient service use, health insurance ownership, age, sex, marital status, educational level, work status, welfare status, type of area, and geographic location. From the logistic regression, the probability of the population to experience catastrophic health expenditure is higher for people in the following categories: use inpatient or outpatient services, do not have health insurance, are elderly, ever-married, not working, not poor, and live in the rural areas or Java island. Disaggregation by outpatient and inpatient service use shows the large gap in the probability of falling into catastrophic health expenditures. The probability for people who used inpatient service is more than four times people who never used the service. Meanwhile, for outpatient service, the probability is almost three times. Therefore, people can strengthen preventive care, especially those with low or no cost, to avoid falling into catastrophic health expenditure.

scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

WHICH HEALTH FINANCING MODEL IS BETTER: TAX-FINANCED OR SOCIAL HEALTH INSURANCE? WHAT DOES INTERNATIONAL EXPERIENCE PROVE?

2021 ◽  
Vol 67 (1) ◽  
pp. 9-9
Author(s):  
E.G. Potapchik ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Structural Characteristics ◽  
Health Expenditures ◽  
Health Financing ◽  
Health Care Expenditures ◽  
Developed Countries ◽  
Financing System ◽  
Financing Model ◽  
The Developed Countries

In Russia disputes on the need to abandon Compulsory Health Insurance (CHI) and return to the tax-based financing are yet to subside. At present, after the statement of the President of the Russian Federation V. Putin about the possibility to establish a state health care corporation, discussions on the issue have only escalated. Purpose. To conduct a comparative assessment of the public health financing model impact on the access and structural characteristics of health care delivery in the developed countries. Material and methods. Assessment of the potential impact of public funding models on the health system performance is carried out by analyzing variations in the main indicators of financial access, health care uptake and health status of the population, achieved in the developed countries with different health financing models. Results. Health care expenditures in countries with CHI are higher than in countries with the tax-based financing model. In countries with CHI the share of administrative expenses is slightly higher than in countries with the tax-based financing system. The share of spending on preventive care is slightly higher in countries with the tax-based financing system. There is a slightly lower level of outpatient and inpatient care uptake in countries with the tax-based financing system compared to countries with CHI. The premature mortality rate in countries with CHI is slightly lower than in countries with the tax-based system. Conclusion. The obtained data indicate that there are no significant differences in the access and structural characteristics of medical care in the health care system of the developed countries with different financing models. The main difference remains the level of health expenditures. In countries with CHI, the level of health expenditures is higher than in countries with the tax-based financing, which is largely due to the existence of a separate source of funding. The level of administrative costs in countries with CHI is also higher than in countries with the tax-based system.

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