Evidence map›Paper›PMID 39049025›Full record

ArticleBMC health services research2024

Decomposing socioeconomic inequality in household out of pocket health expenditures in Pakistan (2010-11-2018-19).

Muhammad Zubair, Lubna Naz, Shyamkumar Sriram

Abstract read
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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Muhammad ZubairCollage of Economics and Social Development, Institute of Business Management(IoBM), Karachi, 75190, Pakistan.
Lubna NazSchool of Economics and Social Sciences, Institute of Business Administration (IBA), Karachi, 75270, Pakistan.
Shyamkumar SriramCollege of Health Sciences and Professions, Ohio University, Athens, OH, 45701, USA. shyam.silverhawk@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe increased socioeconomic inequality in catastrophic health expenditure (CHE) disproportionately affects disadvantaged populations, subjecting them to financial hardships, limiting their access to healthcare, and exacerbating their vulnerability to morbidity.

objectivesThis study examines changes in socioeconomic inequality related to CHE and analyzes the contributing factors responsible for these changes in Pakistan between 2010-11 and 2018-19.

methodsThis paper extracted the data on out-of-pocket health expenditures from the National Health Accounts for 2009-10 and 2017-18. Sociodemographic information was gathered from the Household Integrated Economic Surveys of 2010-11 and 2018-19. CHE was calculated using budget share and the ability-to-pay approaches. To assess socioeconomic inequality in CHE in 2010-11 and 2018-19, both generalized and standard concentration indices were used, and Wagstaff inequality decomposition analysis was employed to explore the causes of socioeconomic inequality in each year. Further, an Oaxaca-type decomposition was applied to assess changes in socioeconomic inequality in CHE over time.

resultsThe concentration index reveals that socioeconomic inequality in CHE decreased in 2018-19 compared to 2010-11 in Pakistan. Despite the reduction in inequality, CHE was concentrated among the poor in Pakistan in 2010-11 and 2018-19. The inequality decomposition analysis revealed that wealth status was the main cause of inequality in CHE over time. The upper wealth quantiles indicated a positive contribution, whereas lower quantiles showed a negative contribution to inequality in CHE. Furthermore, urban residence contributed to pro-rich inequality, whereas employed household heads, private healthcare provider, and inpatient healthcare utilization contributed to pro-poor inequality. A noticeable decline in socioeconomic inequality in CHE was observed between 2010 and 2018. However, inequality remained predominantly concentrated among the lower socio-economic strata.

conclusionThese results underscore the need to improve the outreach of subsidized healthcare and expand social safety nets.

Indexed as

Health ExpendituresSocioeconomic FactorsAdultCatastrophic IllnessFamily CharacteristicsFemaleFinancing, PersonalHealthcare DisparitiesHumansMaleMiddle AgedPakistanCatastrophic health expenditureConcentration indexOaxaca-Blinder decompositionSocioeconomic inequality

Identifiers

PMID39049025
PMCPMC11271023

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