IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0252706.html
   My bibliography  Save this article

Impoverishment impact of out-of-pocket payments for healthcare in rural Bangladesh: Do the regions facing different climate change risks matter?

Author

Listed:
  • Afroza Begum
  • Syed Abdul Hamid

Abstract

Introduction: Out-of-pocket (OOP) payments for healthcare severely affect the current consumption, future health and earnings capacity of poor/underprivileged households and hence it is crucial for priority setting. This study assesses the variation in overall as well as disease-specific impoverishment impact of OOP payments between the regions experiencing different climate change risks, defined as high disaster-prone (HDP) areas and low-disaster-prone (LDP) areas, in Bangladesh. Materials and methods: This paper estimated three poverty measures, such as poverty headcount, poverty intensity and normalized poverty gap for all ailments, catastrophic events, diseases types (communicable, non-communicable (NCDs), and accident and injury), illness conditions (acute and chronic) and hospitalization using 3,791 randomly selected rural households (1,203 from HDP and 2,588 from LDP areas) across the regions. Cost of basic need approach was used for estimating poverty line expenditure. Results: About 13 percent households annually fall into poverty due to OOP outlays for healthcare. Despite having significantly (p-value≤0.01) less OOP payments (HDP areas: BDT 5,117; LDP areas: BDT5,811) the impoverishment impact of OOP payments for healthcare in HDP areas (16.5%) has substantially higher than LDP areas (11.3%). Conclusion: The impoverishment effect due to OOP payments for healthcare in both HDP and LDP areas are high, especially for NCDs and catastrophic healthcare expenditure. However, the situation is bit worse in HDP areas. Preventing the escalation of NCDs as well as catastrophic expenditure and hence reducing the level of impoverishment thereof call for restricting tobacco use, increasing physical activity, encouraging to intake healthy diets, ensuring food safety, controlling air pollution, and improving mental health. Moreover, government should give more emphasis, especially in the HDP areas, on making community clinics more functional through providing screening equipment and training to the Community Health Care Providers for early detection of NCDs, and ensuring availability of medicine all the time. Note that other than community clinics, there is little option for providing healthcare in HDP areas due to poor functionality of public facilities as well as lack of private facilities in HDP areas.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0252706
    DOI: 10.1371/journal.pone.0252706
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252706
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252706&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0252706?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Md Mizanur Rahman & Stuart Gilmour & Eiko Saito & Papia Sultana & Kenji Shibuya, 2013. "Health-Related Financial Catastrophe, Inequality and Chronic Illness in Bangladesh," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-9, February.
    2. 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.
    3. Margherita Giannoni & Theodore Hitiris, 2002. "The regional impact of health care expenditure: the case of Italy," Applied Economics, Taylor & Francis Journals, vol. 34(14), pages 1829-1836.
    4. 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).
    5. Syed Abdul Hamid & Syed M. Ahsan & Afroza Begum & Chowdhury Abdullah Al Asif, 2015. "Inequity in Formal Health Care Use: Evidence from Rural Bangladesh," Journal of International Development, John Wiley & Sons, Ltd., vol. 27(1), pages 36-54, January.
    6. Salem Deenadayalan Vaishnavi & Umakant Dash, 2009. "Catastrophic payments for health care among households in urban Tamil Nadu, India," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 169-184.
    7. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    8. 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.
    9. Ravallion, Martin & Sen, Binayak, 1996. "When Method Matters: Monitoring Poverty in Bangladesh," Economic Development and Cultural Change, University of Chicago Press, vol. 44(4), pages 761-792, July.
    10. Shah Mohammad Fahim & Tofayel Ahmed Bhuayan & Md. Zakiul Hassan & Abu Hena Abid Zafr & Farhana Begum & Md. Mizanur Rahman & Shahinul Alam, 2019. "Financing health care in Bangladesh: Policy responses and challenges towards achieving universal health coverage," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 11-20, January.
    11. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
    12. Yardim, Mahmut Saadi & Cilingiroglu, Nesrin & Yardim, Nazan, 2010. "Catastrophic health expenditure and impoverishment in Turkey," Health Policy, Elsevier, vol. 94(1), pages 26-33, January.
    13. 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.
    14. Pavel, Md Sadik & Chakrabarty, Sayan & Gow, Jeff, 2015. "Cost of illness for outpatients attending public and private hospitals in Bangladesh," MPRA Paper 74491, University Library of Munich, Germany, revised 03 Sep 2016.
    15. Guillem Lopez‐Casasnovas & Joan Costa‐Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish ‘system of health care services’," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 221-235, September.
    16. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health‐care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412, December.
    17. Jonathan A. Patz & Diarmid Campbell-Lendrum & Tracey Holloway & Jonathan A. Foley, 2005. "Impact of regional climate change on human health," Nature, Nature, vol. 438(7066), pages 310-317, November.
    18. 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.
    19. 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.
    20. Kochar, Anjini, 1995. "Explaining Household Vulnerability to Idiosyncratic Income Shocks," American Economic Review, American Economic Association, vol. 85(2), pages 159-164, May.
    Full references (including those not matched with items on IDEAS)

    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. 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.
    2. 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).
    3. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    4. Abdur Razzaque Sarker & S M Zulfiqar Ali & Maruf Ahmed & S M Zahedul Islam Chowdhury & Nausad Ali, 2022. "Out-of-pocket payment for healthcare among urban citizens in Dhaka, Bangladesh," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-20, January.
    5. Dhanaraj, Sowmya, 2014. "Health shocks and coping strategies: State health insurance scheme of Andhra Pradesh, India," WIDER Working Paper Series 003, World Institute for Development Economic Research (UNU-WIDER).
    6. Meriem Oudmane & Fouzi Mourji & Abdeljaouad Ezzrari, 2019. "The impact of out‐of‐pocket health expenditure on household impoverishment: Evidence from Morocco," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1569-1585, October.
    7. 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.
    8. 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.
    9. 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.
    10. Tomson Ogwang & Germano Mwabu, 2024. "Adaptation of the Foster‐Greer‐Thorbecke poverty measures for the measurement of catastrophic health expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2419-2436, October.
    11. Kumara, Ajantha Sisira & Samaratunge, Ramanie, 2017. "Impact of ill-health on household consumption in Sri Lanka: Evidence from household survey data," Social Science & Medicine, Elsevier, vol. 195(C), pages 68-76.
    12. 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.
    13. 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.
    14. Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Catastrophic Economic Consequences of Healthcare Payments: Effects on Poverty Estimates in Egypt, Jordan, and Palestine," Economies, MDPI, vol. 3(4), pages 1-19, November.
    15. 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).
    16. 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.
    17. O'Donnell, Owen, 2024. "Health and health system effects on poverty: A narrative review of global evidence," Health Policy, Elsevier, vol. 142(C).
    18. Shivendra Sangar & Varun Dutt & Ramna Thakur, 2019. "Economic burden, impoverishment, and coping mechanisms associated with out‐of‐pocket health expenditure in India: A disaggregated analysis at the state level," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 301-313, January.
    19. Barnes, Kayleigh & Mukherji, Arnab & Mullen, Patrick & Sood, Neeraj, 2017. "Financial risk protection from social health insurance," Journal of Health Economics, Elsevier, vol. 55(C), pages 14-29.
    20. 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.

    More about this item

    Statistics

    Access and download statistics

    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:plo:pone00:0252706. 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: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    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.