Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan

<p>Abstract</p> <p>Background</p> <p>Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity i...

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Main Authors: Muhammad Malik Ashar, Azam Syed Shah
Format: Article
Language:English
Published: BMC 2012-09-01
Series:International Journal for Equity in Health
Subjects:
Online Access:http://www.equityhealthj.com/content/11/1/51
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author Muhammad Malik Ashar
Azam Syed Shah
author_facet Muhammad Malik Ashar
Azam Syed Shah
author_sort Muhammad Malik Ashar
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap.</p> <p>Methods</p> <p>We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a multiple regression model for the determinants of OOP payments using methods of Ordinary Least Square (OLS). We mainly used social, economic, demographic and health variables in our analysis.</p> <p>Results</p> <p>Median household OOP healthcare in the year 2004-05 was Pakistani Rupees (PKR) 2500 (US$ 41.99) in 2004-05. Household non-food expenditure was the single highest significant predictor of household OOP health expenditure. Household features like literate head and spouse, at least one obstetric delivery in last three years, unsafe water, unhygienic toilet and household belonging to Khyber Pukhtonkhwa (KPK) province were significant positive predictors of OOP payments. Households with male head, bricks used in housing construction, household with at least one child and no elderly, and head of household in a white collar profession were negative predictors of OOP payments.</p> <p>Conclusion</p> <p>Our analysis confirms earlier findings that economic status and number of old aged members are significant positive predictors of OOP payments. This association can direct government to enhance allocations to healthcare and to include program focusing on non-communicable diseases. Our findings suggest further research to explore beneficiaries of government healthcare programs and determinants of high OOP payments by household residing in KPK province than other province. The interaction between white collar profession and their economic status in predicting OOP payments is also an area for further research.</p>
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spelling doaj.art-38139141f73d478b81e518342263c9fd2022-12-21T19:14:26ZengBMCInternational Journal for Equity in Health1475-92762012-09-011115110.1186/1475-9276-11-51Socio-economic determinants of household out-of-pocket payments on healthcare in PakistanMuhammad Malik AsharAzam Syed Shah<p>Abstract</p> <p>Background</p> <p>Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap.</p> <p>Methods</p> <p>We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a multiple regression model for the determinants of OOP payments using methods of Ordinary Least Square (OLS). We mainly used social, economic, demographic and health variables in our analysis.</p> <p>Results</p> <p>Median household OOP healthcare in the year 2004-05 was Pakistani Rupees (PKR) 2500 (US$ 41.99) in 2004-05. Household non-food expenditure was the single highest significant predictor of household OOP health expenditure. Household features like literate head and spouse, at least one obstetric delivery in last three years, unsafe water, unhygienic toilet and household belonging to Khyber Pukhtonkhwa (KPK) province were significant positive predictors of OOP payments. Households with male head, bricks used in housing construction, household with at least one child and no elderly, and head of household in a white collar profession were negative predictors of OOP payments.</p> <p>Conclusion</p> <p>Our analysis confirms earlier findings that economic status and number of old aged members are significant positive predictors of OOP payments. This association can direct government to enhance allocations to healthcare and to include program focusing on non-communicable diseases. Our findings suggest further research to explore beneficiaries of government healthcare programs and determinants of high OOP payments by household residing in KPK province than other province. The interaction between white collar profession and their economic status in predicting OOP payments is also an area for further research.</p>http://www.equityhealthj.com/content/11/1/51Out-Of-Pocket paymentSocial and economic determinantsEquityHealthcare financingDemand for healthHealth policyDeveloping countriesPakistan
spellingShingle Muhammad Malik Ashar
Azam Syed Shah
Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
International Journal for Equity in Health
Out-Of-Pocket payment
Social and economic determinants
Equity
Healthcare financing
Demand for health
Health policy
Developing countries
Pakistan
title Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
title_full Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
title_fullStr Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
title_full_unstemmed Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
title_short Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan
title_sort socio economic determinants of household out of pocket payments on healthcare in pakistan
topic Out-Of-Pocket payment
Social and economic determinants
Equity
Healthcare financing
Demand for health
Health policy
Developing countries
Pakistan
url http://www.equityhealthj.com/content/11/1/51
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