Raúl Del Pozo-Rubio1,2, Román Mínguez-Salido3, Isabel Pardo-García4,5, Francisco Escribano-Sotos6,2. 1. Department of Economics and Finance, University of Castilla-La Mancha, Avda, Los Alfares, 44, 16071, Cuenca, Spain. 2. Research Group Economy, Food and Society, University of Castilla-La Mancha, Ciudad Real, Spain. 3. Department of Public Economy, Statistics and Economic Policy, University of Castilla-La Mancha, Avda, Los Alfares, 44, 16071, Cuenca, Spain. 4. Department of Public Economy, Statistics and Economic Policy, University of Castilla-La Mancha, Plaza de la Universidad, s/n, 02071, Albacete, Spain. isabel.pardo@uclm.es. 5. Research Group Economy, Food and Society, University of Castilla-La Mancha, Ciudad Real, Spain. isabel.pardo@uclm.es. 6. Department of Economics and Finance, University of Castilla-La Mancha, Plaza de la Universidad, s/n, 02071, Albacete, Spain.
Abstract
OBJECTIVE: An increasing number of persons across the world require long-term care (LTC). In Spain, access to LTC involves individuals incurring out-of-pocket (OOP) expenditure. There is a large body of literature on the incidence of catastrophic OOP payments in access and participation in health systems, but not in the field of LTC nor the determinants of these expenses. Our aim was to analyse the socio-demographic and economic factors associated with different levels of catastrophic LTC expenditure in the form of private out-of-pocket payments among dependent persons in Spain. MATERIALS AND METHODS: The study used the Spanish Disability and Dependency Survey (SDDS) conducted by the Spanish National Statistics Institute to obtain the socioeconomic, demographic and health profiles. The households were classified into those below the poverty threshold and those above the threshold of catastrophe, using measures of impoverishment and catastrophe. We estimated two logistic regression models, one binary (impoverishment) and one ordinal (catastrophe). RESULTS: The results show that OOP expenditure on LTC increases the probability of impoverishment by 18.90%. The factors associated with higher probability of experiencing catastrophe were age, being single, widowed or separated, lower levels of household income and education, higher level of dependence and living in an autonomous community with lower per capita income. CONCLUSIONS: These findings highlight the need to include exemptions or insurance in the design of LTC policies to protect dependent persons from the risk of financial burden.
OBJECTIVE: An increasing number of persons across the world require long-term care (LTC). In Spain, access to LTC involves individuals incurring out-of-pocket (OOP) expenditure. There is a large body of literature on the incidence of catastrophic OOP payments in access and participation in health systems, but not in the field of LTC nor the determinants of these expenses. Our aim was to analyse the socio-demographic and economic factors associated with different levels of catastrophic LTC expenditure in the form of private out-of-pocket payments among dependent persons in Spain. MATERIALS AND METHODS: The study used the Spanish Disability and Dependency Survey (SDDS) conducted by the Spanish National Statistics Institute to obtain the socioeconomic, demographic and health profiles. The households were classified into those below the poverty threshold and those above the threshold of catastrophe, using measures of impoverishment and catastrophe. We estimated two logistic regression models, one binary (impoverishment) and one ordinal (catastrophe). RESULTS: The results show that OOP expenditure on LTC increases the probability of impoverishment by 18.90%. The factors associated with higher probability of experiencing catastrophe were age, being single, widowed or separated, lower levels of household income and education, higher level of dependence and living in an autonomous community with lower per capita income. CONCLUSIONS: These findings highlight the need to include exemptions or insurance in the design of LTC policies to protect dependent persons from the risk of financial burden.
Authors: Samuel López-López; Raúl Del Pozo-Rubio; Marta Ortega-Ortega; Francisco Escribano-Sotos Journal: Int J Environ Res Public Health Date: 2021-01-21 Impact factor: 3.390
Authors: Luz María Peña-Longobardo; Isaac Aranda-Reneo; Juan Oliva-Moreno; Svenja Litzkendorf; Isabelle Durand-Zaleski; Eduardo Tizzano; Julio López-Bastida Journal: Int J Environ Res Public Health Date: 2020-08-05 Impact factor: 3.390