OBJECTIVES: We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden. METHODS: We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries. RESULTS: Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden. CONCLUSION: To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.
OBJECTIVES: We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden. METHODS: We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries. RESULTS: Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden. CONCLUSION: To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.
Authors: Ophira M Ginsburg; Timothy P Hanna; Theodore Vandenberg; Anil A Joy; Mark Clemons; Melaku Game; Ronald Maccormick; Lorraine M Elit; Barry Rosen; Yasmin Rahim; William Geddie; Simon B Sutcliffe; Mary Gospodarowicz Journal: CMAJ Date: 2012-04-10 Impact factor: 8.262
Authors: Saleh A Bawazir; Mohammed A Alkudsi; Abdullah S Al Humaidan; Maher A Al Jaser; Larry D Sasich Journal: Saudi Pharm J Date: 2012-11-12 Impact factor: 4.330
Authors: Catherine E Vialle-Valentin; Brian Serumaga; Anita K Wagner; Dennis Ross-Degnan Journal: Health Policy Plan Date: 2014-09-24 Impact factor: 3.344
Authors: Veronika J Wirtz; Hans V Hogerzeil; Andrew L Gray; Maryam Bigdeli; Cornelis P de Joncheere; Margaret A Ewen; Martha Gyansa-Lutterodt; Sun Jing; Vera L Luiza; Regina M Mbindyo; Helene Möller; Corrina Moucheraud; Bernard Pécoul; Lembit Rägo; Arash Rashidian; Dennis Ross-Degnan; Peter N Stephens; Yot Teerawattananon; Ellen F M 't Hoen; Anita K Wagner; Prashant Yadav; Michael R Reich Journal: Lancet Date: 2016-11-08 Impact factor: 79.321