Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis
The current study investigated the association between out-of-pocket health expenditure and poverty using macroeconomic data from a sample of 145 countries from 2000 to 2017. In particular, it was examined whether the relationship between out-of-pocket health expenditure and poverty was contingent o...
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| Format: | Article |
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MDPI AG
2021-05-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/9/5/536 |
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| author | Abdalla Sirag Norashidah Mohamed Nor |
| author_facet | Abdalla Sirag Norashidah Mohamed Nor |
| author_sort | Abdalla Sirag |
| collection | DOAJ |
| description | The current study investigated the association between out-of-pocket health expenditure and poverty using macroeconomic data from a sample of 145 countries from 2000 to 2017. In particular, it was examined whether the relationship between out-of-pocket health expenditure and poverty was contingent on a certain threshold level of out-of-pocket health spending. The dynamic panel threshold method, which allows for the endogeneity of the threshold regressor (out-of-pocket health expenditure), was used. Three indicators were adopted as poverty measures, namely the poverty headcount ratio, the poverty gap index, and the poverty gap squared index. At the same time, out-of-pocket health expenditure was measured as a percentage of total health expenditure. The results showed the validity of the estimated threshold models, indicating that only beyond the turning point, which was about 29 percent, that out-of-pocket health spending led to increased poverty. When heterogeneity was controlled for in the sample, using the World Bank income classification, the findings showed variations in the estimated threshold, with higher values for the low- and lower-middle-income groups, as compared to the high-income group. For the lower-income groups, below the threshold for out-of-pocket health expenditure, it had a positive or insignificant effect on poverty reduction, while it led to higher poverty above the threshold. Further, the sampled countries were divided into regions, according to the World Health Organization. Generally, improving health care systems through tolerable levels of out-of-pocket health expenditure is an inevitable step toward better health coverage and poverty reduction in many developing countries. |
| first_indexed | 2024-03-10T11:43:08Z |
| format | Article |
| id | doaj.art-2c3f6bde33964a868d98c73b75e8cd17 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T11:43:08Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
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| series | Healthcare |
| spelling | doaj.art-2c3f6bde33964a868d98c73b75e8cd172023-11-21T18:16:27ZengMDPI AGHealthcare2227-90322021-05-019553610.3390/healthcare9050536Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold AnalysisAbdalla Sirag0Norashidah Mohamed Nor1School of Business and Economics, Universiti Putra Malaysia, Serdang 43400 UPM, MalaysiaSchool of Business and Economics, Universiti Putra Malaysia, Serdang 43400 UPM, MalaysiaThe current study investigated the association between out-of-pocket health expenditure and poverty using macroeconomic data from a sample of 145 countries from 2000 to 2017. In particular, it was examined whether the relationship between out-of-pocket health expenditure and poverty was contingent on a certain threshold level of out-of-pocket health spending. The dynamic panel threshold method, which allows for the endogeneity of the threshold regressor (out-of-pocket health expenditure), was used. Three indicators were adopted as poverty measures, namely the poverty headcount ratio, the poverty gap index, and the poverty gap squared index. At the same time, out-of-pocket health expenditure was measured as a percentage of total health expenditure. The results showed the validity of the estimated threshold models, indicating that only beyond the turning point, which was about 29 percent, that out-of-pocket health spending led to increased poverty. When heterogeneity was controlled for in the sample, using the World Bank income classification, the findings showed variations in the estimated threshold, with higher values for the low- and lower-middle-income groups, as compared to the high-income group. For the lower-income groups, below the threshold for out-of-pocket health expenditure, it had a positive or insignificant effect on poverty reduction, while it led to higher poverty above the threshold. Further, the sampled countries were divided into regions, according to the World Health Organization. Generally, improving health care systems through tolerable levels of out-of-pocket health expenditure is an inevitable step toward better health coverage and poverty reduction in many developing countries.https://www.mdpi.com/2227-9032/9/5/536out-of-pocket health expenditurepovertypoverty headcountpoverty gapdynamic panel threshold |
| spellingShingle | Abdalla Sirag Norashidah Mohamed Nor Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis Healthcare out-of-pocket health expenditure poverty poverty headcount poverty gap dynamic panel threshold |
| title | Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis |
| title_full | Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis |
| title_fullStr | Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis |
| title_full_unstemmed | Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis |
| title_short | Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis |
| title_sort | out of pocket health expenditure and poverty evidence from a dynamic panel threshold analysis |
| topic | out-of-pocket health expenditure poverty poverty headcount poverty gap dynamic panel threshold |
| url | https://www.mdpi.com/2227-9032/9/5/536 |
| work_keys_str_mv | AT abdallasirag outofpockethealthexpenditureandpovertyevidencefromadynamicpanelthresholdanalysis AT norashidahmohamednor outofpockethealthexpenditureandpovertyevidencefromadynamicpanelthresholdanalysis |