Catastrophic health expenditure and household impoverishment in Togo.

IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Yacobou Sanoussi, Alexandre Yedjannavo Zounmenou, Muriel Ametoglo
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Abstract

Background: The main way of financing healthcare in low-income countries continues to be out-of-pocket payments. Despite the efforts of national authorities and international partners to protect households from impoverishment arising from seeking healthcare, the risk of incurring catastrophic healthcare expenses remains very high for households in developing countries. This study aims to analyse catastrophic health expenditures and their effects on household impoverishment in Togo.

Design and methods: Data were obtained from the CWIQ survey, a nationally representative survey conducted in 2015 among 2400 households.We calculated the incidence and the intensity of catastrophic health expenditures in Togo through various thresholds and then estimated the effects of these expenditures on the level of households' impoverishment by determining poverty levels using consumption expenditure before and after making payments for healthcare.

Results: The results indicate that the incidence of catastrophic expenditure varies between 6% and 57% depending on the thresholds used. Households at risk of catastrophic expenditure spend between 19% and 64% of their spending on healthcare. Based on total expenditure and above 20%, the richest households are more prone to catastrophic health expenditures. The findings also show that the incidence of impoverishment caused by health expenditure payments is 8.2% in relative terms and 4.52% in absolute terms. In Togo, 4.52% of households are impoverished by catastrophic health expenditures. This impoverishment effect is greater for male-headed households.

Conclusions: Health system reforms aiming at accessibility to quality care and the development of pre-payment mechanisms will promote the earlier use of healthcare services and thus reduce the higher healthcare costs generated by later attendance at them.

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多哥灾难性的卫生支出和家庭贫困。
背景:低收入国家卫生保健融资的主要方式仍然是自费支付。尽管国家当局和国际伙伴努力保护家庭不因寻求医疗保健而致贫,但发展中国家家庭承担灾难性医疗费用的风险仍然很高。本研究旨在分析多哥灾难性卫生支出及其对家庭贫困的影响。设计与方法:数据来源于2015年在全国2400户家庭中进行的具有代表性的CWIQ调查。我们通过不同的阈值计算了多哥灾难性卫生支出的发生率和强度,然后通过使用支付医疗费用前后的消费支出来确定贫困水平,估计了这些支出对家庭贫困水平的影响。结果:结果表明,根据所使用的阈值,灾难性支出的发生率在6%至57%之间变化。面临灾难性支出风险的家庭将19%至64%的支出用于医疗保健。根据总支出和超过20%,最富有的家庭更容易出现灾难性的卫生支出。研究结果还表明,卫生支出引起的贫困率相对为8.2%,绝对为4.52%。在多哥,4.52%的家庭因灾难性的卫生支出而陷入贫困。这种贫困效应在男性户主家庭中更为明显。结论:以获得优质医疗服务为目标的卫生体制改革和预付费机制的发展将促进医疗服务的早期使用,从而降低因晚就诊而产生的较高医疗费用。
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来源期刊
Journal of Public Health Research
Journal of Public Health Research PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.70
自引率
4.30%
发文量
116
审稿时长
10 weeks
期刊介绍: The Journal of Public Health Research (JPHR) is an online Open Access, peer-reviewed journal in the field of public health science. The aim of the journal is to stimulate debate and dissemination of knowledge in the public health field in order to improve efficacy, effectiveness and efficiency of public health interventions to improve health outcomes of populations. This aim can only be achieved by adopting a global and multidisciplinary approach. The Journal of Public Health Research publishes contributions from both the “traditional'' disciplines of public health, including hygiene, epidemiology, health education, environmental health, occupational health, health policy, hospital management, health economics, law and ethics as well as from the area of new health care fields including social science, communication science, eHealth and mHealth philosophy, health technology assessment, genetics research implications, population-mental health, gender and disparity issues, global and migration-related themes. In support of this approach, JPHR strongly encourages the use of real multidisciplinary approaches and analyses in the manuscripts submitted to the journal. In addition to Original research, Systematic Review, Meta-analysis, Meta-synthesis and Perspectives and Debate articles, JPHR publishes newsworthy Brief Reports, Letters and Study Protocols related to public health and public health management activities.
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