107 lines
3.6 KiB
YAML
107 lines
3.6 KiB
YAML
abstract: 'Background Catastrophic health expenditure (CHE) is well established as
|
|
|
|
an indicator of financial protection on which there is extensive
|
|
|
|
literature. However, most works analyse mainly low to middle income
|
|
|
|
countries and do not address the different distributional dimensions of
|
|
|
|
CHE. We argue that, besides incidence, the latter are crucial to better
|
|
|
|
grasp the scope and nature of financial protection problems. Our
|
|
|
|
objectives are therefore to analyse the evolution of CHE in a high
|
|
|
|
income country, considering both its incidence and distribution. Methods
|
|
|
|
Data are taken from the last three waves of the Portuguese Household
|
|
|
|
Budget Survey conducted in 2005/2006, 2010/2011 and 2015/2016. To
|
|
|
|
identify CHE, the approach adopted is capacity to pay/normative food
|
|
|
|
spending, at the 40\% threshold. To analyse distribution, concentration
|
|
|
|
curves and indices (CI) are used and adjusted odds ratios are
|
|
|
|
calculated. Results The incidence of CHE was 2.57, 1.79 and 0.46\%, in
|
|
|
|
2005, 2010 and 2015, respectively. CHE became highly concentrated among
|
|
|
|
the poorest (the respective CI evolved from - 0.390 in 2005 to - 0.758
|
|
|
|
in 2015) and among families with elderly people (the absolute CI evolved
|
|
|
|
from 0.520 in 2005 to 0.740 in 2015). Absolute CI in geographical
|
|
|
|
context also increased over time (0.354 in 2015, 0.019 in 2005).
|
|
|
|
Medicines represented by far the largest share of catastrophic payments,
|
|
|
|
although, in this case concentration decreased (the median share of
|
|
|
|
medicines diminished from 93 to 43\% over the period analysed).
|
|
|
|
Contrarily, the weight of expenses incurred with consultation fees has
|
|
|
|
been growing (even for General Practitioners, despite the NHS coverage
|
|
|
|
of primary care). Conclusions The incidence of CHE and inequality in its
|
|
|
|
distribution might progress in the same direction or not, but most
|
|
|
|
importantly policy makers should pay attention to the distributional
|
|
|
|
dimensions of CHE as these might provide useful insight to target
|
|
|
|
households at risk. Greater concentration of CHE can actually be
|
|
|
|
regarded as an opportunity for policy making, because interventions to
|
|
|
|
tackle CHE become more confined. Monitoring the distribution of payments
|
|
|
|
across services can also contribute to early detection of emerging (and
|
|
|
|
even, unexpected) drivers of catastrophic payments.'
|
|
affiliation: 'Quintal, C (Corresponding Author), Univ Coimbra, Fac Econ, FEUC, CeBER,CEISUC,
|
|
Ave Dias da Silva 165, P-3004512 Coimbra, Portugal.
|
|
|
|
Quintal, Carlota, Univ Coimbra, Fac Econ, FEUC, CeBER,CEISUC, Ave Dias da Silva
|
|
165, P-3004512 Coimbra, Portugal.'
|
|
article-number: '145'
|
|
author: Quintal, Carlota
|
|
author-email: qcarlota@fe.uc.pt
|
|
author_list:
|
|
- family: Quintal
|
|
given: Carlota
|
|
da: '2023-09-28'
|
|
doi: 10.1186/s12939-019-1044-9
|
|
eissn: 1475-9276
|
|
files: []
|
|
journal: INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
|
|
keywords: 'Catastrophic health expenditure; Financial protection; Inequality;
|
|
|
|
Portugal'
|
|
keywords-plus: 'OF-POCKET PAYMENTS; FINANCIAL PROTECTION; CONCENTRATION INDEX; CARE
|
|
|
|
EXPENDITURE; HOUSEHOLDS; BINARY; EQUITY'
|
|
language: English
|
|
month: SEP 18
|
|
number: '1'
|
|
number-of-cited-references: '46'
|
|
orcid-numbers: Quintal, Carlota/0000-0002-8306-3431
|
|
papis_id: 796da9f461919558f1e622fbd378a865
|
|
ref: Quintal2019evolutioncatastrophi
|
|
researcherid-numbers: 'Quintal, Carlota/AAE-9866-2020
|
|
|
|
'
|
|
times-cited: '10'
|
|
title: 'Evolution of catastrophic health expenditure in a high income country: incidence
|
|
versus inequalities'
|
|
type: article
|
|
unique-id: WOS:000486991400001
|
|
usage-count-last-180-days: '1'
|
|
usage-count-since-2013: '7'
|
|
volume: '18'
|
|
web-of-science-categories: Public, Environmental \& Occupational Health
|
|
year: '2019'
|