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Determinants of catastrophic healthcare expenditure in Peru

Author

Listed:
  • Diego Proaño Falconi

    (King’s College and St. Thomas’ Hospitals
    Universidad Peruana Cayetano Heredia)

  • Eduardo Bernabé

    (King’s College and St. Thomas’ Hospitals)

Abstract

The aims of this study were to assess factors associated with catastrophic healthcare expenditure (CHE) and the burden of out-of-pocket (OOP) payments for specific healthcare services in Peru. We used data from 30,966 households that participated in the 2016 National Household Survey (Encuesta Nacional de Hogares, ENAHO). Participants reported household characteristics and expenditure on ten healthcare services. CHE was defined as healthcare spending equal to or higher than 40% of the household’s capacity to pay. The associations of various household characteristics and OOP payments for specific healthcare services with CHE were assessed in logistic regression models. Poorer, rural and smaller households as well as those with older adults and individuals with chronic conditions had greater odds of facing CHE. According to the estimates from the adjusted regression model, healthcare services could be grouped into three groups. Medical tests, surgery and medication were in the first group with odds ratios (ORs) between 6.43 and 4.72. Hospitalisation, outpatient, dental and eye care were in the second group with ORs between 2.61 and 1.46. Child care, maternity care and other healthcare services (such as contraceptives, rehabilitation, etc.) were in the third group with non-significant ORs. Many Peruvian households are forced to finance their healthcare through OOP payments, burdening their finances to the extent of affecting their living standards.

Suggested Citation

  • Diego Proaño Falconi & Eduardo Bernabé, 2018. "Determinants of catastrophic healthcare expenditure in Peru," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 425-436, December.
  • Handle: RePEc:kap:ijhcfe:v:18:y:2018:i:4:d:10.1007_s10754-018-9245-0
    DOI: 10.1007/s10754-018-9245-0
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    1. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    2. Daniel Cotlear & Somil Nagpal & Owen Smith & Ajay Tandon & Rafael Cortez, 2015. "Going Universal," World Bank Publications - Books, The World Bank Group, number 22011, December.
    3. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    4. Marieke Krol & Werner Brouwer, 2014. "How to Estimate Productivity Costs in Economic Evaluations," PharmacoEconomics, Springer, vol. 32(4), pages 335-344, April.
    5. Kim, Younhee & Yang, Bongmin, 2011. "Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea," Health Policy, Elsevier, vol. 100(2-3), pages 239-246, May.
    6. Mohd Masood & Aubrey Sheiham & Eduardo Bernabé, 2015. "Household Expenditure for Dental Care in Low and Middle Income Countries," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-11, April.
    7. Sedona Sweeney & Anna Vassall & Nicola Foster & Victoria Simms & Patrick Ilboudo & Godfather Kimaro & Don Mudzengi & Lorna Guinness, 2016. "Methodological Issues to Consider When Collecting Data to Estimate Poverty Impact in Economic Evaluations in Low‐income and Middle‐income Countries," Health Economics, John Wiley & Sons, Ltd., vol. 25, pages 42-52, February.
    8. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    9. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2013. "Measuring the catastrophic and impoverishing effect of household health care spending in Serbia," Social Science & Medicine, Elsevier, vol. 78(C), pages 17-25.
    10. Ties Boerma & Patrick Eozenou & David Evans & Tim Evans & Marie-Paule Kieny & Adam Wagstaff, 2014. "Monitoring Progress towards Universal Health Coverage at Country and Global Levels," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-8, September.
    11. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
    12. Hacer Özgen Narcı & İsmet Şahin & Hasan Yıldırım, 2015. "Financial catastrophe and poverty impacts of out-of-pocket health payments in Turkey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 255-270, April.
    13. Kim, Younhee & Yang, Bongmin, 2011. "Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea," Health Policy, Elsevier, vol. 100(2), pages 239-246.
    14. Alshamsan, Riyadh & Leslie, Hannah & Majeed, Azeem & Kruk, Margaret, 2017. "Financial hardship on the path to Universal Health Coverage in the Gulf States," Health Policy, Elsevier, vol. 121(3), pages 315-320.
    15. Sedona Sweeney & Anna Vassall & Nicola Foster & Victoria Simms & Patrick Ilboudo & Godfather Kimaro & Don Mudzengi & Lorna Guinness, 2016. "Methodological Issues to Consider When Collecting Data to Estimate Poverty Impact in Economic Evaluations in Low‐income and Middle‐income Countries," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 42-52, February.
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    3. Nguyen Thi Thu Thuong & Yme Van Den Berg & Tran Quang Huy & Do Anh Tai & Bui Nu Hoang Anh, 2021. "Determinants of catastrophic health expenditure in Vietnam," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 316-333, March.

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    More about this item

    Keywords

    Health services/utilization; Health expenditures; Developing countries; Adults;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

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