Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

Rashidul Alam Mahumud; Abdur Razzaque Sarker; Marufa Sultana; Ziaul Islam; Jahangir Khan; Alec Morton

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자료유형: 학술저널

저자정보: Rashidul Alam Mahumud Abdur Razzaque Sarker Marufa Sultana Ziaul Islam Jahangir Khan Alec Morton

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제50권 제2호

발행연도: 2017.1

수록면: 91 - 99 (9page)

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Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

#Out-of-pocket #Risk pooling mechanism #Social financial safety #Gross domestic product per capita #Bangladesh

참고문헌 (33)

참고문헌 신청

Alemayehu B / 2004 / The lifetime distribution of health care costs / Health Serv Res 39(3):627~642

Sarker AR / 2013 / Cost of illness for cholera in a high risk urban area in Bangladesh: an analysis from household perspective / BMC Infect Dis 13:518

Hoque ME / 2015 / Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh / Trop Med Int Health 20(10):1368~1375

Say L / 2007 / A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context / Bull World Health Organ 85(10):812~819

Daga S / 2015 / Out-of-pocket nonmedical expenses associated with out-patient treatment of common childhood illnesses / J Trop Pediatr 61(3):226~228

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