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