IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v67y2008i12p2027-2035.html
   My bibliography  Save this article

Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand

Author

Listed:
  • Somkotra, Tewarit
  • Lagrada, Leizel P.

Abstract

Equitable health financing was embodied in the reform strategies of Thailand's health care system when the country moved towards implementing the Universal Coverage (UC) policy in 2001. This study aimed to measure the pattern of household out-of-pocket payments for health care and to examine the financial catastrophe and impoverishment due to such payments during the transitional period (pre- and post-Universal Coverage policy implementation) in Thailand. This study used the nationally representative Socioeconomic Surveys in 2000 (pre-UC), 2002, and 2004 (post-UC), which contained data from 24747, 34758 and 34843 individual households, respectively. The proportion of out-of-pocket payments for health care as a share of household living standards among Thai households shows a decreasing pattern during the observed period. Moreover, the incidence and intensity of catastrophic payments for health care decline from the pre-UC to post-UC period. The distribution of incidence and the intensity of catastrophic payments for health care across quintiles also indicate that the lower quintile group (1st and 2nd quintiles) incurs lower catastrophic health care payments compared to the higher quintile group. The UC policy is also effective in preventing impoverishment due to out-of-pocket payments for health care since both the poverty headcount and poverty gap decline from the pre-UC to post-UC period. This study provides important evidence that the UC policy implementation is a valuable social protection and safety net strategy that contributes to the prevention of financial catastrophe and impoverishment due to out-of-pocket payments for health care. In conclusion, the UC policy in Thailand achieves one of the goals of improving the health system through equitable health care financing by reducing financial catastrophe and impoverishment due to out-of-pocket payments for health care.

Suggested Citation

  • Somkotra, Tewarit & Lagrada, Leizel P., 2008. "Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand," Social Science & Medicine, Elsevier, vol. 67(12), pages 2027-2035, December.
    • Handle: RePEc:eee:socmed:v:67:y:2008:i:12:p:2027-2035
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00460-7
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. 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.
    2. O'Donnell, Owen & van Doorslaer, Eddy & Rannan-Eliya, Ravi P. & Somanathan, Aparnaa & Adhikari, Shiva Raj & Akkazieva, Baktygul & Harbianto, Deni & Garg, Charu C. & Hanvoravongchai, Piya & Herrin, Ale, 2008. "Who pays for health care in Asia?," Journal of Health Economics, Elsevier, vol. 27(2), pages 460-475, March.
    3. Tangcharoensathien, Viroj & Harnvoravongchai, Piya & Pitayarangsarit, Siriwan & Kasemsup, Vijj, 2000. "Health impacts of rapid economic changes in Thailand," Social Science & Medicine, Elsevier, vol. 51(6), pages 789-807, September.
    4. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan‐Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184, November.
    5. Pannarunothai, Supasit & Mills, Anne, 1997. "The poor pay more: Health-related inequality in Thailand," Social Science & Medicine, Elsevier, vol. 44(12), pages 1781-1790, June.
    6. Xu, Ke & Evans, David B. & Kadama, Patrick & Nabyonga, Juliet & Ogwal, Peter Ogwang & Nabukhonzo, Pamela & Aguilar, Ana Mylena, 2006. "Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda," Social Science & Medicine, Elsevier, vol. 62(4), pages 866-876, February.
    7. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    8. Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," The World Bank Economic Review, World Bank, vol. 21(1), pages 93-123.
    9. Falkingham, Jane, 2004. "Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan," Social Science & Medicine, Elsevier, vol. 58(2), pages 247-258, January.
    10. Suraratdecha, Chutima & Saithanu, Somying & Tangcharoensathien, Viroj, 2005. "Is universal coverage a solution for disparities in health care?: Findings from three low-income provinces of Thailand," Health Policy, Elsevier, vol. 73(3), pages 272-284, September.
    11. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    12. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862, Elsevier.
    13. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    14. Menno Pradhan & Nicholas Prescott, 2002. "Social risk management options for medical care in Indonesia," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 431-446, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Chen, Mingsheng & Xu, Lizheng & Si, Lei & Wang, Zhonghua & Jan, Stephen, 2023. "Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China," Economic Modelling, Elsevier, vol. 121(C).
    2. Afroza Begum & Syed Abdul Hamid, 2021. "Impoverishment impact of out-of-pocket payments for healthcare in rural Bangladesh: Do the regions facing different climate change risks matter?," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-21, June.
    3. Kyriopoulos, Ilias & Nikoloski, Zlatko & Mossialos, Elias, 2021. "Financial protection in health among the middle-aged and elderly: Evidence from the Greek economic recession," Health Policy, Elsevier, vol. 125(9), pages 1256-1266.
    4. Amir Fazaeli & Mohmmad Hadian & Aziz Rezapour & Ali Fazaeli, 2016. "Assessing the Distribution of Household Financial Contribution to Health System: A Case Study of Iran," Global Journal of Health Science, Canadian Center of Science and Education, vol. 8(10), pages 233-233, October.
    5. Cherri Zhang & Md Shafiur Rahman & Md Mizanur Rahman & Alfred E Yawson & Kenji Shibuya, 2019. "Trends and projections of universal health coverage indicators in Ghana, 1995-2030: A national and subnational study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-19, May.
    6. Bolaji Samson Aregbeshola & Samina Mohsin Khan, 2018. "Determinants of catastrophic health expenditure in Nigeria," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(4), pages 521-532, May.
    7. Susan W. Parker & Joseph Saenz & Rebeca Wong, 2018. "Health Insurance and the Aging: Evidence From the Seguro Popular Program in Mexico," Demography, Springer;Population Association of America (PAA), vol. 55(1), pages 361-386, February.
    8. Kim, Sujin & Kwon, Soonman, 2015. "Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea," Social Science & Medicine, Elsevier, vol. 138(C), pages 241-247.
    9. Kim, Chang-O & Joung, Won Oh, 2014. "Effect of the Crisis Assistance Program on poverty transition for seriously ill people in South Korea: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 101(C), pages 28-35.
    10. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    11. Elham Ahmadnezhad & Adrianna Murphy & Rezvaneh Alvandi & Zhaleh Abdi, 2019. "The impact of health reform in Iran on catastrophic health expenditures: Equity and policy implications," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1833-1845, October.
    12. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," Tinbergen Institute Discussion Papers 13-067/V, Tinbergen Institute.
    13. Li, Cheng & Yu, Xuan & Butler, James R.G. & Yiengprugsawan, Vasoontara & Yu, Min, 2011. "Moving towards universal health insurance in China: Performance, issues and lessons from Thailand," Social Science & Medicine, Elsevier, vol. 73(3), pages 359-366, August.
    14. Syed M. Ahsan & Syed Abdul Hamid & Shubhasish Barua, 2012. "Utilisation of Formal Health Care and Out-of-Pocket Payments in Rural Bangladesh," Working Papers 13, Institute of Microfinance (InM).
    15. Thoresen, Stian H. & Fielding, Angela, 2011. "Universal health care in Thailand: Concerns among the health care workforce," Health Policy, Elsevier, vol. 99(1), pages 17-22, January.
    16. Syed Hamid & Syed Ahsan & Afroza Begum, 2014. "Disease-Specific Impoverishment Impact of Out-of-Pocket Payments for Health Care: Evidence from Rural Bangladesh," Applied Health Economics and Health Policy, Springer, vol. 12(4), pages 421-433, August.
    17. Abdur Razzaque Sarker & Marufa Sultana & Khorshed Alam & Nausad Ali & Nurnabi Sheikh & Raisul Akram & Alec Morton, 2021. "Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2106-2117, November.
    18. Asankha Pallegedara, 2018. "Impacts of chronic non-communicable diseases on households’ out-of-pocket healthcare expenditures in Sri Lanka," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 301-319, September.
    19. 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.
    20. HyunWoo Jung & Kwang-Soo Lee, 2022. "What Policy Approaches Were Effective in Reducing Catastrophic Health Expenditure? A Systematic Review of Studies from Multiple Countries," Applied Health Economics and Health Policy, Springer, vol. 20(4), pages 525-541, July.
    21. Xiaocang Xu & Haoran Yang, 2022. "Elderly chronic diseases and catastrophic health expenditure: an important cause of Borderline Poor Families’ return to poverty in rural China," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-10, December.
    22. Niëns, L.M. & Brouwer, W.B.F., 2013. "Measuring the affordability of medicines: Importance and challenges," Health Policy, Elsevier, vol. 112(1), pages 45-52.
    23. Limwattananon, Supon & Neelsen, Sven & O'Donnell, Owen & Prakongsai, Phusit & Tangcharoensathien, Viroj & van Doorslaer, Eddy & Vongmongkol, Vuthiphan, 2015. "Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand," Journal of Public Economics, Elsevier, vol. 121(C), pages 79-94.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    2. 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.
    3. Kim, Chang-O & Joung, Won Oh, 2014. "Effect of the Crisis Assistance Program on poverty transition for seriously ill people in South Korea: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 101(C), pages 28-35.
    4. Arnousse Beaulière & Siaka Touré & Pierre-Kébreau Alexandre & Koko Koné & Alex Pouhé & Bertin Kouadio & Neige Journy & Jérôme Son & Virginie Ettiègne-Traoré & François Dabis & Serge Eholié & Xavier An, 2010. "The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Côte d'Ivoire," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-7, June.
    5. Nikolaos Grigorakis & Christos Floros & Haritini Tsangari & Evangelos Tsoukatos, 2017. "Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 261-287, September.
    6. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    7. Richard Mussa, 2016. "Exit from catastrophic health payments: a method and an application to Malawi," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 163-174, June.
    8. Raúl Del Pozo-Rubio & Isabel Pardo-García & Francisco Escribano-Sotos, 2020. "Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment," IJERPH, MDPI, vol. 17(1), pages 1-19, January.
    9. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
    10. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    11. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    12. Syed M. Ahsan & Syed Abdul Hamid & Shubhasish Barua, 2012. "Utilisation of Formal Health Care and Out-of-Pocket Payments in Rural Bangladesh," Working Papers 13, Institute of Microfinance (InM).
    13. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    14. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    15. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan‐Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184, November.
    16. Kyriopoulos, Ilias & Nikoloski, Zlatko & Mossialos, Elias, 2021. "Financial protection in health among the middle-aged and elderly: Evidence from the Greek economic recession," Health Policy, Elsevier, vol. 125(9), pages 1256-1266.
    17. Md. Mizanur Rahman & Md. Rashedul Islam & Md. Shafiur Rahman & Fahima Hossain & Ashraful Alam & Md. Obaidur Rahman & Jenny Jung & Shamima Akter, 2022. "Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis," Health Economics Review, Springer, vol. 12(1), pages 1-11, December.
    18. Van Minh, Hoang & Kim Phuong, Nguyen Thi & Saksena, Priyanka & James, Chris D. & Xu, Ke, 2013. "Financial burden of household out-of pocket health expenditure in Viet Nam: Findings from the National Living Standard Survey 2002–2010," Social Science & Medicine, Elsevier, vol. 96(C), pages 258-263.
    19. Navneet Manchanda & Dil Bahadur Rahut, 2021. "Inpatient Healthcare Financing Strategies: Evidence from India," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 33(6), pages 1729-1767, December.
    20. Ligane Séne & Momath Cissé, 2015. "Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal," International Journal of Health Economics and Management, Springer, vol. 15(3), pages 307-328, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:67:y:2008:i:12:p:2027-2035. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.