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Progress on impoverishing health spending in 122 countries : a retrospective observational study (anglais)

The goal of universal health coverage (UHC) requires that families who get needed health care do not suffer financial hardship as a result. This can be measured by instances of impoverishment, when a household’s consumption including out-of-pocket spending on health is more than the poverty line but its consumption, excluding out-of-pocket spending, is less than the poverty line. This links UHC directly to the policy goal of reducing poverty. The authors measure the incidence and depth of impoverishment as the difference in the poverty head count and poverty gap with and without out-of-pocket spending included in household total consumption. The authors find impoverishment due to out-of-pocket spending even in countries where the entire population is officially covered by a health insurance scheme or by national or subnational health services. Incidence is negatively correlated with the share of total health spending channeled through social security funds and other government agencies. Out-of-pocket spending on health can add to the poverty head count and the depth of poverty by diverting household spending from non-health budget items.


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    Wagstaff, Adam;Wagstaff,Robert Adam Stephen, Flores,Gabriela, Smitz,Marc-Francois, Hsu,Justine, Chepynoga,Kateryna, Eozenou,Patrick Hoang-Vu

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    Article de revue

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  • Titre du rapport

    Progress on impoverishing health spending in 122 countries : a retrospective observational study

  • Mots clé

    relative poverty line; poverty head count; share of health spending; extreme poverty line; international poverty line; depth of poverty; social security fund; health insurance scheme; consumption per capita; gross domestic product; absolute poverty line; national health insurance; rate of change; flow of service; household living standard; data on consumption; point of use; median poverty line; public health service; Declaration of Interests; catastrophic health spending; expenditures on health; poverty gap; health expenditure; pocket spending; global estimate; government agency; household consumption; financial protection; household survey; regional estimates; average change; regional median; country population; Learning and Innovation Credit; total consumption; econometric model; health payments; income inequality; financial hardship; funding source; medical expense; private consumption; consumption aggregate; scatter plot; marginal effect; household spending; pocket expenditure; Regional Studies; global incidence; data sharing; government expenditure; health coverage; previous study; private insurance; rockefeller foundation; household characteristic; catastrophic expenditure; regression results; service availability; Exchange Rates; mandatory contribution; observational study; restricted use; food expenditure; small fraction; asian populations; health finance; poor household; anonymous reviewer; consumer price; survey data; quality check; point estimate; food spending; poverty estimate; macroeconomic indicator; informal payment; governmental organisation; asian countries; formal insurance; coverage rate; need of care; monitoring indicator; survey instrument; original work; adverse health; data gaps; financing arrangement; food intake; policy perspective; richer countries



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