ArticleHealth services research2016
High Out-of-Pocket Medical Spending among the Poor and Elderly in Nine Developed Countries.
Article in Health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Funding paediatric surgery procedures in sub-Saharan Africa.Malawi medical journal : the journal of Medical Association of Malawi · 2019Pooled it
- Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review.International journal for equity in health · 2019Pooled it
- Out-of-Pocket Costs and Health-Related Social Needs Among Households With Children.JAMA network open · 2026Article
- Mortality and morbidity burden associated with smoking: evidence from a 1.6 million cohort in Hong Kong.BMC medicine · 2026Article
- Personal and Family Perspectives Regarding Neurodegenerative Disorder Risk.Journal of community medicine & public health · 2026Article
- Observational
- Pregnancy to postpartum: Analyzing dropouts and socioeconomic predictors of continuum of maternal healthcare in India.Dialogues in health · 2025Article
- Catastrophic and impoverishing out-of-pocket payments for health care in Poland in 2013-2021.Health policy OPEN · 2025Article
- Observational
- 'I Have Never Been in That Kind of All-Consuming Pain … I Did Not Know What Else to Do': The Journey to Hospital Admission With Low Back Pain From the Perspectives of Patients.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Informal employment and high burden of out-of-pocket healthcare payments among older workers: evidence from the Longitudinal Ageing Study in India.Health policy and planning · 2025Article
- Stakeholders' perspectives about challenges, strategies and outcomes of importance associated with adherence to appropriate polypharmacy in older patients - A qualitative study.Exploratory research in clinical and social pharmacy · 2024Article
- The causal effect of catastrophic health expenditure on poverty in Poland.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Out-of-pocket expenditure, need, utilisation, and private health insurance in the Australian healthcare system.International journal of health economics and management · 2024Article
- Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare.Health economics review · 2024Article
- Article
- Random forest model used to predict the medical out-of-pocket costs of hypertensive patients.Frontiers in public health · 2024Article
- Article
- Addressing Financial Barriers to Health Care Among People Who are Low-Income and Insured in New York City, 2014-2017.Journal of community health · 2023Article
- Comparison of catastrophic out-of-pocket medical expenditure among older adults in the United States and South Korea: what affects the apparent difference?BMC health services research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe design of health insurance, and the role out-of-pocket (OOP) payments play in it, is a key policy issue as rising health costs have encouraged greater cost-sharing measures. This paper compares the percentage of Americans spending large amounts OOP to meet their health needs with percentages in eight other developed countries. By disaggregating by age and income, the paper focuses on the poor and elderly populations within each. DATA SOURCE: The study uses nationally representative household survey data made available through the Luxembourg Income Study. It includes nations with high, medium, and low levels of OOP spending. STUDY
designHouseholds have high medical spending when their OOP expenditures exceed a threshold share of income. I calculate the share of each nation's population, as well as subpopulations within it, with high OOP expenditures. PRINCIPAL
findingsThe United States is not alone in exposing large numbers of citizens to high OOP expenses. In six of the other eight countries, one-quarter or more of low-income citizens devoted at least 5 percent of their income to OOP expenses, and in all but two countries, more than 1 in 10 elderly citizens had high medical expenses.
conclusionsFor some populations in the sample nations, health insurance does not provide adequate financial protection and likely contributes to inequities in health care delivery and outcomes.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.