Who pays? Out-of-Pocket Health Spending and Equity Implications in the Middle East and North Africa
Author(s)
Elgazzar, HebaArfa, Chokri
Salti, Nisreen
Majbouri, Mehdi
Salehi-Isfahani, Djavad
Raad, Firas
Chaaban, Jad
Fesharaki, Sanaz
Mataria, Awad
Keywords
INFORMAL SECTORHEALTH CARE ACCESS
SUSTAINABILITY
INPATIENT HOSPITAL CARE
DISADVANTAGED COMMUNITIES
HEALTH CARE FINANCING
INPATIENT CARE
HEALTH OUTCOMES
EMPOWERMENT
PUBLIC INSURANCE SCHEMES
PROTECTION MECHANISMS
HEALTH CARE SPENDING
ILLNESS
PUBLIC SECTORS
PRIMARY HEALTH CARE SERVICES
HEALTH CARE RESOURCES
HEALTH INSURANCE SCHEME
FINANCIAL BARRIERS
PRIVATE SECTOR
FEE-FOR-SERVICE BASIS
PHYSICIAN
PHYSICIANS
RURAL HOUSEHOLDS
ANTENATAL CARE
RURAL REGIONS
HEALTH NEEDS
PERFORMANCE INDICATORS
HEALTH SERVICE USE
SAFETY NETS
PUBLIC COVERAGE
HEALTH CARE PROVIDERS
HEALTH SECTOR REFORM
HEALTH EXPENDITURE
PRIVATE HEALTH CARE SERVICES
FINANCE OF HEALTH CARE
MEDICAL COSTS
HEALTH SYSTEM
POLICY RESEARCH
INEQUITY IN HEALTH
HOSPITAL CARE
HEALTH CARE COSTS
HEALTH CARE PROFESSIONALS
INFANT MORTALITY RATE
MALNUTRITION
INSURANCE PLANS
PHARMACEUTICAL EXPENDITURES
PUBLIC INSURANCE
HEALTH FINANCING
HEALTH CARE SERVICES
DETERMINANTS OF HEALTH
INFANT MORTALITY
PRIVATE CLINICS
MEDICAL ASSOCIATION
PUBLIC EXPENDITURE
HOSPITALS
PRIVATE HEALTH SERVICES
VISITS
LOW-INCOME COUNTRIES
INTERNATIONAL COMPARISONS
INCOME GROUPS
HEALTH CARE FACILITIES
PUBLIC HEALTH INSURANCE
HEALTH STATUS
CATASTROPHIC EXPENDITURES
HEALTH SYSTEMS
ECONOMIC GROWTH
WORKERS
PHARMACEUTICAL SERVICES
NATIONAL HEALTH SPENDING
HEALTH SECTOR
HEALTH SERVICE
HEALTH ORGANIZATION
BASIC HEALTH SERVICES
NATIONAL HEALTH INSURANCE
FINANCIAL PROTECTION
NATIONAL HEALTH INSURANCE FUND
HEALTHCARE
HEALTH SERVICE UTILIZATION
POCKET PAYMENTS FOR HEALTH CARE
DIAGNOSTIC SERVICES
IMMUNIZATION
SOCIAL SECURITY SCHEMES
NATIONAL HEALTH
HEALTH FINANCING SCHEME
BASIC HEALTH CARE
HEALTH SPENDING
PROVISION OF SERVICES
DRUGS
INCOME COUNTRIES
DEMAND FOR HEALTH
PRIVATE SPENDING
DECISION MAKING
LIVING STANDARDS
HUMAN DEVELOPMENT
HEALTH POLICY
FAMILY PLANNING
DEMAND FOR HEALTH CARE
ACCESS TO HEALTH SERVICES
INPATIENT HOSPITAL
INSURANCE PREMIUMS
HEALTH PROJECT
LABOR MARKETS
ABILITY TO PAY
ACCESS TO HEALTH CARE
INFANTS
SOCIAL EXCLUSION
INTERVENTION
MORTALITY
NUTRITION
HEALTH EXPENDITURES
VACCINATION
ELIGIBLE BENEFICIARIES
REHABILITATION
QUALITY OF HEALTH CARE
PRIVATE HEALTH INSURANCE
POVERTY REDUCTION
FINANCIAL RISK
REPRODUCTIVE HEALTH
HEALTH CARE NEEDS
HEALTH INSURANCE
QUALITY OF CARE
PUBLIC SECTOR
HEALTH CARE USE
PUBLIC HEALTH INSURANCE SCHEMES
PRIVATE INSURANCE
SOCIAL HEALTH INSURANCE SCHEMES
PAYMENTS FOR HEALTH CARE
RURAL AREAS
HEALTH INTERVENTIONS
PATIENTS
BASIC SERVICES
FEE-FOR-SERVICE
QUALITY OF HEALTH
HEALTH ECONOMICS
DENTAL CARE
PRIMARY CARE
CHILD HEALTH SERVICES
COSTS OF HEALTH CARE
CLINICS
HEALTH CARE
HEALTH INDICATORS
HOUSEHOLD EXPENDITURE
CATASTROPHIC HEALTH SPENDING
SOCIAL SECURITY
PROVIDER INCENTIVES
INCOME HOUSEHOLDS
SOCIAL WELFARE
CHILD HEALTH
MEDICATION
HEALTH CARE EXPENDITURE
HEALTH INSURANCE COVERAGE
NATIONAL HEALTH EXPENDITURES
HEALTH SERVICE DELIVERY
HEALTH CARE PERSONNEL
INFORMATION SYSTEMS
HEALTH CONDITIONS
FINANCIAL CONSEQUENCES
POCKET PAYMENTS BY HOUSEHOLDS
COSTS OF CARE
PROTECTIONS
HR
HEALTH CARE COVERAGE
OUTPATIENT SERVICES
SOCIAL HEALTH INSURANCE
HEALTH CARE EXPENDITURES
HEALTH SERVICES
HEALTH CARE SYSTEM
USE OF HEALTH CARE SERVICES
POCKET PAYMENTS
LOW INCOME
HEALTH CARE FINANCE
PUBLIC PROVIDERS
INCOME
DELIVERY OF HEALTH CARE
HEALTH WORKERS
PRIMARY HEALTH CARE
PUBLIC HEALTH
EXPOSURE
DIABETES
Full record
Show full item recordOnline Access
http://hdl.handle.net/10986/13606Abstract
Ensuring affordable, effective health care and financial protection against the adverse effects of household out-of-pocket (OOP) health expenditures represents an important policy objective in most countries, yet relatively little evidence exists regarding patterns and implications of household health expenditures in the Middle East and North Africa (MENA) region. This paper examines the scope of out-of-pocket expenditures and their implications on living standards and policy reforms in six MENA countries including Yemen, the West Bank and Gaza, Egypt, Iran, Tunisia, and Lebanon. Results show that OOP payments represent a relatively high share of total national health care financing at 49 percent on average in the MENA region as of 2006. Households pay an average of 6 percent of their total household expenditure on health. Most of this OOP is spent on medications, doctor visits and diagnostic services. Lower-income and rural households generally face greater financial risk; yet this is reversed where private health services are utilized and paid for more frequently by higher-income groups. 7 to 13 percent of households face particularly high OOP payments, or catastrophic expenditures equal to at least 10 percent of household spending. Poverty rates tend to increase by up to 20 percent after health care spending is accounted for. Results are discussed in light of ongoing policy efforts to strengthen social protection for health care.Date
2013-05-29Identifier
oai:openknowledge.worldbank.org:10986/13606http://hdl.handle.net/10986/13606
Copyright/License
http://creativecommons.org/licenses/by/3.0/Collections
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