Assessing Factors Associated with Catastrophic Healthcare Expenditure in Côte d’Ivoire: Evidence from the Household Living Standard Survey 2015
International Journal of Health Economics and Policy
Volume 4, Issue 4, December 2019, Pages: 143-150
Received: Sep. 30, 2019;
Accepted: Oct. 23, 2019;
Published: Nov. 13, 2019
Views 130 Downloads 43
Akissi Regine Attia-Konan, Department of Public Health, Hydrology and Toxicology, University of Felix Houphouet Boigny, Abidjan, Cote d’Ivoire
Agbaya Serge Stephane Oga, Department of Public Health, Hydrology and Toxicology, University of Felix Houphouet Boigny, Abidjan, Cote d’Ivoire
Kouame Koffi, Department of Public Health, Hydrology and Toxicology, University of Felix Houphouet Boigny, Abidjan, Cote d’Ivoire
Jerome Kouame, Department of Public Health, Hydrology and Toxicology, University of Felix Houphouet Boigny, Abidjan, Cote d’Ivoire
Amadou Toure, National Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
Luc Kouadio, Department of Public Health, Hydrology and Toxicology, University of Felix Houphouet Boigny, Abidjan, Cote d’Ivoire
Catastrophic healthcare expenditure (CHE) occurs in all countries and is responsible for inequalities in access to health care, particularly in low- and middle-income countries. The objective of this work is to analyse the determinants of CHEs in households living in Côte d'Ivoire. The data for the study are from the national household living standards survey conducted from January 23 to March 25, 2015 by the National Statistics Institute of Côte d’Ivoire (Institut National de la Statistique de Côte d'Ivoire). A one-way analysis and logistic regression were conducted to measure the association between CHEs and the socio-demographic, economic and health characteristics of households. The sample consisted of 12,899 households. Nearly 4% of households had experienced CHEs after completing OOPs. CHEs were more frequent in households including people over 65 years of age (OR: 4.75; 95% CI: 1.66-13.58), with chronic disease (OR: 2.10; 95% CI: 1.43-3.08), with more comfortable living conditions. Households without health insurance experienced fewer CHEs (OR: 0.29; 95% CI: 0.09-0.85) with large households including people over 65 years of age (OR: 0.60 95% CI: 0.40-0.91). This work highlighted socio-demographic and health determinants of CHEs. The reduction of CHEs involves considering social and individual factors.
Akissi Regine Attia-Konan,
Agbaya Serge Stephane Oga,
Assessing Factors Associated with Catastrophic Healthcare Expenditure in Côte d’Ivoire: Evidence from the Household Living Standard Survey 2015, International Journal of Health Economics and Policy.
Vol. 4, No. 4,
2019, pp. 143-150.
O’Donnell O, van Doorslaer E, Rannan-Eliya RP, Somanathan A, Adhikari SR, Akkazieva B et al. Who pays for health care in Asia? Journal of Health Economics. 2008, 27: 460-75.
World Health Organization. The world Health Report: Health systems financing: The path to universal coverage. Geneva. 2010; 128 p.
World Health Organization. World Bank. Tracking universal health coverage: first global monitoring report. Geneva. Washington DC. 2015.
Xu K, Evans DB, Carrin G, Aguilar-Rivera AM, Musgrove P, et al. Protecting households from catastrophic health spending. Health Affairs (Millwood). 2007; 26: 972–83.
Hsu J, Flores G, Evans D, Mills A, Hanson K. Measuring financial protection against catastrophic health expenditures methodological challenges for global monitoring. 2018; 17 (1).
Xu K. Distribution of health payments and catastrophic expenditures: methodology. Geneva: World Health Organization; 2005.
Wagstaff A, Flores G, Hsu J, Smitz M-F, Chepynoga K, Buisman L R, Van Wilgenburg K, Eozenou P. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health. 2018; 6 (2): e169-179.
World Health Organization. State of health inequality: Indonesia. Geneva: World Health Organization. 2017.
Su TT, Pokhrel S, Gbangou A, Flessa S. Determinants of houeshold health expenditure on western institutional health care. The European Journal of Health Economics. 2006; 7 (3): 195-203.
Chuma J, Maina T. Catastrophic health care spending and impoverishment in Kenya. BMC Health Services Research 2012; 413 (12).
Whitehead M, Dahlgren G, Evans T. Equity and Health sector reforms: can low income countries escape the medical poverty trap? Lancet. 2001; 358: 833-836.
Samba M, Attia R, Diabagaté A, Djaha K, Baujot M. Utilisation des services de santé en Côte d’Ivoire. Analyse situationnelle (2007). Médecine d’Afrique Noire. 2015; 62 (7): 367-372.
Ministère de la Santé et de la lutte contre le SIDA. Comptes de la Santé 2013. République de Côte d’Ivoire. 2015.
Xu K, Evans D B Kawabata, K, Zeramdini R, Klavus J, Murray C J L. Household catastrophic health expenditure: a multicountry analysis. Lancet 2003; 362: 111–117.
Attia AR, Oga AS, Koffi K, Kouadio KL, Monnet D. Satisfaction des besoins en médicaments dans le cadre de la gratuité ciblée chez les enfants de 0 à 59 mois, 2012, Abidjan. Cahier de Santé Publique. 2015; 14 (2): 94-102.
Ridde V, Morestin F. A scoping review of the literature on the abolition of user fees in health care services in Africa. Health Policy Plan. 2011; 26 (1): 1-11.
Adisa O. Investigating determinants of catastrophic health spending among poorly insured elderly households in urban Nigeria. International Journal for Equity in Health. 2015; 14: 79.
Okoronkwo IL, Ekpemiro JN, Okwor EU, Okpala PU, Adeyemo FO. Economic burden and catastrophic cost among people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria. BMC Res Notes. 2015; 8: 527.
Wagstaff A, Van Doorslaer E. Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ. 2003; 12: 921-34.
Khan JAM, Ahmed S, Evans TG. Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh—an estimation of financial risk protection of universal health coverage. Health policy and planning. 2017; 32 (8): 1102-1110.
Li Y, Wu Q, Xu L, Legge D, Hao Y et al. Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance. Bull World Health Organ. 2012; 90: 664-671.
Barasa E W, Maina T, Ravishankar N. Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya. International Journal for Equity in Health. 2017; 16: 31.
Jacobs B, de Groot R, Fernandes Antunes A. Financial access to health care for older people in Cambodia: 10-year trends (2004-14) and determinants of catastrophic health expenses. Int J Equity Health. 2016; 15: 94.
Feder J, Moon M, Scanlon W. Medicare reform: nibbling at catastrophic costs. Health Affairs (Millwood). 1987; 6: 5–19.
Saksena P, Hsu J, Evans DB. Financial risk protection and universal health coverage: evidence and measurement challenges. Plos medicine. 2014; 11 (9). Expenditure in Korea. BMC Health Services Research. 2015; 15: 26.
Jaspers L, Colpani V, Chaker L, van der Lee SJ, Muka T et al. The global impact of non-communicable diseases on.
Choi J-W, Kim J-H, Yoo K-B, Park E-C. Association between chronic disease and catastrophic health households and impoverishment: a systematic review. Eur J Epidemiol. 2015; 30 (3): 163-188.
Panday A, Ploubidis G, Clarke L, Dandona L. Trends in catastrophic health expenditure in India: 1993 to 2014. Bul World Health Organ. 2018; 96: 18-28.
Myint C-J, Pavlova M, Groot W. Catastrophic health care expenditure in Myanmar: policy implications in leading progress towards universal health coverage. Int J Equity Health. 2019; 18: 118.
Attia Konan AR, Oga ASS, Touré A, Kouadio L. Determinants of Utilization of Modern Health Facilities in Côte D'ivoire: Evidence from a National Household Survey. African Journal of Health Economics. 2018; 7 (1): 1-15.
Kusi A, Hansen KS, Asante FA, Enemark U. Does the National Health Insurance Scheme provide financial protection to households in Ghana? BMC Health Services Research. 2015; 15: 331.
Xu Y, Gao J, Zhou Z, Xue Q, Yang J et al. Measurement and explanation of socioeconomic inequality in catastrophic health care expenditure: evidence from the rural areas of Shaanxi Province. BMC Health Research. 2015; 15: 256.
Yardim MS, Cilingiroglu N, Yardim N. Catastrophic health expenditure and impoverishment in Turkey. Health policy. 2010; 94: 26-33.
Bazie G W, Adimassie M T Modern health services utilization and associated factors in North East Ethiopia. Plos one. 2017; 12 (9).