Refining estimates of catastrophic healthcare expenditure: an application in the Indian context
Tóm tắt
Empirics of catastrophic healthcare expenditure, especially in the Indian context, are often based on consumption expenditure data that inadequately informs about the ability to pay. Use of such data can generate a pro-rich bias in the estimation of catastrophic expenditure thereby suggesting greater concentration of such expenditures among richer households. To improve upon the existing approach, this paper suggests a multidimensional approach to comprehend the incidence of catastrophic expenditure. Here, we integrate the information on health expenditure with other social and economic parameters of deprivation. An empirical illustration is provided by using nationally representative survey on morbidity and healthcare in India. The results of the multidimensional approach are consistent with the theoretical underpinnings of the ability-to-pay approach and emphasizes on the severity of the problem in rural areas. The suggested methodology is flexible and allows for context-specific prioritization in selection of parameters of vulnerability while estimating the incidence of catastrophic expenditures.
Tài liệu tham khảo
citation_journal_title=Health Affairs; citation_title=A look at catastrophic medical expenses and the poor; citation_author=S Berki; citation_volume=5; citation_issue=4; citation_publication_date=1986; citation_pages=138-145; citation_doi=10.1377/hlthaff.5.4.138; citation_id=CR1
citation_title=The cost of catastrophic illness; citation_publication_date=1978; citation_id=CR2; citation_author=H Birnbaum; citation_publisher=D. C. Heath and Company
Cameron, A. C., & Trivedi, P. K. (2005). Microeconometrics: methods and applications. Cambridge: Cambridge University Press.
Deaton, A., & Dreze, J. (2002). Poverty and Inequality in India: A re-examination. Economic and Political Weekly, 37(36).
Dilip, T. R., & Duggal, R. (2002). Incidence of non-fatal health outcomes and debt in Urban India, Draft paper presented for urban research symposium, 9–11 December 2002, at World bank, Washigton D.C.
citation_journal_title=Health Policy; citation_title=Catastrophic health payments and health insurance: Some counterintuitive evidence from one low-income country; citation_author=B Ekman; citation_volume=83; citation_publication_date=2007; citation_pages=304-13; citation_doi=10.1016/j.healthpol.2007.02.004; citation_id=CR6
citation_title=Insuring the nation’s health; citation_publication_date=1981; citation_id=CR7; citation_author=J Feder; citation_publisher=The Urban Institute Press
citation_journal_title=The Public Interest; citation_title=A new approach to national health insurance; citation_author=MS Feldstein; citation_volume=23; citation_publication_date=1971; citation_pages=93; citation_id=CR8
citation_journal_title=Health Economics; citation_title=Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty; citation_author=G Flores; citation_volume=17; citation_issue=12; citation_publication_date=2008; citation_pages=1393-1412; citation_doi=10.1002/hec.1338; citation_id=CR9
citation_journal_title=Health Policy and Planning; citation_title=Reducing out-of-pocket expenditures to reduce poverty: a disaggregate analysis at rural urban and state level in India; citation_author=CC Garg, AA Karan; citation_volume=24; citation_publication_date=2009; citation_pages=116-128; citation_doi=10.1093/heapol/czn046; citation_id=CR10
Ghosh, S. (2011). Catastrophic payments and impoverishment due to out of pocket health spending. Economic and Political Weekly, 46(47).
National Health Accounts. (2005). National Health Accounts, India (2001–2002). New Delhi: Ministry of Health and Family Welfare, Government of India.
citation_journal_title=Health Policy and Planning; citation_title=Detecting changes in financial protection: creating evidence for policy in Estonia; citation_author=J Habicht; citation_volume=21; citation_issue=6; citation_publication_date=2006; citation_pages=421-431; citation_doi=10.1093/heapol/czl026; citation_id=CR13
citation_journal_title=Econometrica; citation_title=Sample selection bias as a specification error; citation_author=J Heckman; citation_volume=47; citation_issue=1; citation_publication_date=1979; citation_pages=153-61; citation_doi=10.2307/1912352; citation_id=CR14
citation_title=The financial impact of catastrophic illness as measured in the CHAS-NORC National Survey; citation_publication_date=1975; citation_id=CR15; citation_author=J Kasper; citation_publisher=University of Chicago
citation_journal_title=Bulletin of the World Health Organisation; citation_title=Catastrophic and poverty impacts of health payments: results from national household surveys in Thailand; citation_author=S Limwattananon; citation_volume=85; citation_issue=8; citation_publication_date=2007; citation_pages=600-06; citation_doi=10.2471/BLT.06.033720; citation_id=CR16
Mahal, A., Sakthivel, S., & Nagpal, S. (2005). National Health Accounts for India. In National Commission on Macroeconomics and Health (NCMH). Financing and Delivery of Health Care Services in India. NCMH background papers. New Delhi: Ministry of Health and Family Welfare, Government of India, pp. 256–63.
citation_title=Who benefits from public sector health spending in India?; citation_publication_date=2002; citation_id=CR18; citation_author=A Mahal; citation_publisher=National Council for Applied Economic Research
Mohanti, B. K., et al. (2011). The Economic burden of cancer. Economic and Political Weekly, 46(43).
Ministry of Health and Family Welfare. (2005). Report of the National Commission on Macroeconomics and Health. New Delhi: Ministry of Health and Family Welfare, Government of India.
NSSO (National Sample Survey Organisation). (2006). Morbidity health care and the condition of aged. Report No 507. New Delhi: Ministry of Statistics and Programme Implementation.
citation_title=Analysing health equity using household survey data: A guide to techniques and their implementation; citation_publication_date=2008; citation_id=CR22; citation_author=O O’Donnell; citation_publisher=The World Bank
citation_journal_title=Journal of Health Economics; citation_title=Who pays for healthcare in Asia; citation_author=O O’Donnell; citation_volume=27; citation_issue=2; citation_publication_date=2005; citation_pages=460-475; citation_doi=10.1016/j.jhealeco.2007.08.005; citation_id=CR23
citation_title=Analysing catastrophic health expenditure in India: Concepts, determinants and policy implications, WP-2010-001; citation_publication_date=2010; citation_id=CR24; citation_author=R Pal; citation_publisher=Indira Gandhi Institute of Development Research
citation_title=Better health systems for India’s Poor: Findings, analysis and options; citation_publication_date=2002; citation_id=CR25; citation_author=D Peters; citation_publisher=World Bank
citation_journal_title=Health Economics; citation_title=Social risk management options for medical care in Indonesia; citation_author=M Pradhan, N Prescott; citation_volume=11; citation_publication_date=2002; citation_pages=431-46; citation_doi=10.1002/hec.689; citation_id=CR26
citation_journal_title=Development; citation_title=The Great Indian Poverty Debate; citation_author=SG Reddy; citation_volume=50; citation_issue=2; citation_publication_date=2007; citation_pages=166-71; citation_doi=10.1057/palgrave.development.1100378; citation_id=CR27
citation_journal_title=Social Science and Medicine; citation_title=Household strategies to cope with the economic costs of illness; citation_author=R Sauerborn, A Adams, M Hien; citation_volume=43; citation_publication_date=1996; citation_pages=291-301; citation_doi=10.1016/0277-9536(95)00375-4; citation_id=CR28
Sengupta, A., Kannan, K. P., & Raveendran, G. (2008). India’s common people: Who are they, how many are they and where do they live? Economic and Political Weekly, 43(11)
Shukla, R., Shatrugn, V., & Srivatsan, R. (2011). Aarogyasri healthcare model: Advantage private sector. Economic and Political Weekly, 46(49).
citation_journal_title=Health Affairs; citation_title=Which households are at risk of catastrophic health spending: Experience in thailand after universal coverage; citation_author=T Somkotra, LP Lagrada; citation_volume=28; citation_issue=3; citation_publication_date=2009; citation_pages=w467-w478; citation_doi=10.1377/hlthaff.28.3.w467; citation_id=CR31
Subramanian, S. (2011). The poverty line: Getting it wrong again. Economic and Political Weekly, XLVI(48), 37–42
UNDP (2010) Human development report: The real wealth of nations: pathways to human development. United Nations development programme.
citation_journal_title=Health Economics; citation_title=Catastrophic payments for health care in Asia; citation_author=E Doorslaer; citation_volume=16; citation_issue=11; citation_publication_date=2007; citation_pages=1159-1184; citation_doi=10.1002/hec.1209; citation_id=CR34
citation_title=Utilisation of an expenditure on healthcare in India; citation_publication_date=1994; citation_id=CR35; citation_author=P Visaria; citation_author=A Gumber; citation_publisher=Gujarat Institute for Development Research
citation_title=Morbidity, healthcare utilisation and expenditure pattern in Andhra Pradesh, Kerala, Madhya Pradesh and Punjab; 1986–87; citation_publication_date=1996; citation_id=CR36; citation_author=P Visaria; citation_publisher=Gujarat Institute for Development Research
citation_journal_title=Health Economics; citation_title=Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998; citation_author=A Wagstaff, E Doorslaer; citation_volume=12; citation_issue=11; citation_publication_date=2003; citation_pages=921-34; citation_doi=10.1002/hec.776; citation_id=CR37
Wagstaff, A. (2008). Measuring financial protection in health. World bank policy research working paper no. 4554. Washington D.C.: The World Bank.
citation_journal_title=Health Policy; citation_title=Measuring financial protection in health in the United States; citation_author=HR Waters; citation_volume=69; citation_issue=3; citation_publication_date=2004; citation_pages=339-49; citation_doi=10.1016/j.healthpol.2004.01.003; citation_id=CR39
World Health Assembly. (2005). Sustainable health financing, universal coverage and social health insurance.
http://apps.who.int/gb/ebwhalpdf_filesIWHA58/WHA58_33-en.pdf
.
citation_journal_title=Health Services Research; citation_title=Families with catastrophic health care expenditures; citation_author=L Wyszewianski; citation_volume=21; citation_issue=5; citation_publication_date=1986; citation_pages=617-634; citation_id=CR41
citation_journal_title=The Lancet; citation_title=Household catastrophic health expenditure: A multicountry analysis; citation_author=K Xu; citation_volume=362; citation_issue=9378; citation_publication_date=2003; citation_pages=111-117; citation_doi=10.1016/S0140-6736(03)13861-5; citation_id=CR42
citation_journal_title=Health Policy; citation_title=Catastrophic health expenditure and impoverishment in Turkey; citation_author=MS Yardim; citation_volume=94; citation_issue=1; citation_publication_date=2010; citation_pages=26-33; citation_doi=10.1016/j.healthpol.2009.08.006; citation_id=CR43