ArticleHealth economics review2022
Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis.
Article in Health economics review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Catastrophic health expenditure and associated factors in low-, lower-middle and upper-middle-income countries: systematic review and meta-analysis.Global health action · 2026Pooled it
- The socioeconomic and health system determinants of financial protection indicators: a global systematic review (2008-2023).BMJ global health · 2025Pooled it
- Understanding variation in catastrophic health expenditure from socio-ecological aspect: a systematic review.BMC public health · 2024Pooled it
- Obesity Related Out-of-Pocket Expenditure and Productivity Loss: Evidence From Cross-Sectional Study in Bangladesh.Health science reports · 2026Article
- Determinants of Healthcare-Seeking Preferences of Female Sex Workers: A Cross-Sectional Study From the South-Western Region of Bangladesh.Health science reports · 2026Article
- Socio economic vulnerability and forgone health care among tribal population: a cross-sectional study from a block of Nagpur district in central India.BMC public health · 2026Article
- Cost of diabetes and hypertension care among patients in rural Bangladesh: a cross-sectional study.BMC public health · 2026Article
- Article
- Reducing private health expenditure in Greece: the case for regulated complementary health insurance.Frontiers in public health · 2026Article
- The price of equality: determinants of the convergence in delivery costs in Bangladesh.Frontiers in public health · 2026Article
- Measuring health financing vulnerability due to reductions in official development assistance: A conceptual framework with empirical application across 47 African countries.PLOS global public health · 2026Article
- Illness to poverty in India: a qualitative exploration of hardship financing for healthcare.International journal for equity in health · 2025Article
- Shared decision-making in cancer care in Bangladesh: evidence from a resource-constrained setting.Journal of cancer research and clinical oncology · 2025Article
- A Simple Measure of Catastrophic Health Expenditures.Health economics · 2025Article
- Article
- Unmet healthcare needs, out-of-pocket payments and catastrophic health expenditures among hypertensive adults in Bangladesh.BMC health services research · 2025Article
- Knowledge, attitudes, and practices toward disease management among alopecia areata patients.BMC public health · 2025Article
- Cost of diarrhoea: a household perspective from seven countries in the Global Enteric Multicentre Study (GEMS).BMJ paediatrics open · 2025Article
- Replenish Revenue by Low-Cost Medicines, an Institution-Specific Action to Improve Access to High-Cost Medicines Used for Chronic Illness in Ethiopia: Narrative Review.Health science reports · 2025Article
- Barriers to contraceptive use among people living with diabetes and/or hypertension: a qualitative study.BMC public health · 2025Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnsuring access to health services for all is the main goal of universal health coverage (UHC) plan. Out-of-pocket (OOP) payment still remains the main source of funding for healthcare in Bangladesh. The association between barriers to accessing healthcare and over-reliance on OOP payments has not been explored in Bangladesh using nationally representative household survey data. This study is a novel attempt to examine the burden of OOP payment and forgone healthcare in Bangladesh, and further explores the inequalities in catastrophic health expenditures (CHE) and forgone healthcare at the national and sub-national levels.
methodsThis study used data from the most recent nationally representative cross-sectional survey, Bangladesh Household Income and Expenditure Survey, conducted in 2016-17 (N = 39,124). In order to identify potential determinants of CHE and forgone healthcare, multilevel Poisson regression was used. Inequalities in CHE and forgone healthcare were measured using the slope index of inequality.
resultsAround 25% of individuals incurred CHE and 14% of the population had forgone healthcare for any reasons. The most common reasons for forgone healthcare were treatment cost (17%), followed by none to accompany or need for permission (5%), and distance to health facility (3%). Multilevel analysis indicated that financial burden and forgone care was higher among households with older populations or chronic illness, and those who utilize either public or private health facilities. Household consumption quintile had a linear negative association with forgone care and positive association with CHE.
conclusionThis study calls for incorporation of social safety net in health financing system, increase health facility, and gives priority to the disadvantaged population to ensure access to health services for all.
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