ArticleInternational journal of public health2024
Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan.
Article in International journal of public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Contribution of Medication Expenditures to Catastrophic Health Expenditures in Iran: An Inequality Analysis.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2026Article
- Article
- Exploring patient perceptions of dentist demeanour in Pakistan: a mixed methods analysis using the Urdu translated dental belief survey.BMC oral health · 2026Article
- The association between disease status and health-related quality of life: evidence from a cross-sectional survey across mainland China.Health and quality of life outcomes · 2026Article
- Universal Health Coverage in Pakistan: Challenges, Reforms, and the Road to 2030.Annals of global health · 2026Review
- Exploring risk factors associated with catastrophic health expenditure on diarrhea management in Karachi, Pakistan, 2022-2024.PLOS global public health · 2026Article
- The crime of surviving: Suicide recriminalization and mental health in Pakistan.PLOS mental health · 2026Article
- When injury costs too much: the catastrophic costs for spinal cord injury in Iran.BMC health services research · 2025Article
- Economic Burden and Clinical Epidemiology of Dialysis: A Cross-Sectional Analysis of Chronic Kidney Disease Patients.Cureus · 2025Article
- Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan.International journal of public health · 2024Article
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4 authors.
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Abstract
Objectives: In Pakistan, healthcare utilization is linked to out-of-pocket payments (OOP) which disproportionately affect low-income households. We investigated socioeconomic inequality in OOP and catastrophic health expenditures (CHEs), and the contribution of sociodemographic factors to these inequalities. Methods: Socioeconomic inequalities were quantified using the concentration index (CI), and the slope (SII) and relative (RII) indices of inequality using data from three rounds of Household Integrated Economic Survey (2007-08, 2011-12, and 2018-19). Decomposition analyses were conducted using the Wagstaff and Erreygers approach. Results: OOP payments increased from PKR 127 (2007-08) to PKR 250 (2018-19). CHEs in the most deprived quintile (Q1) changed from 8.3% (2007-08) to 13.7% (2018-19), and for the least deprived quintile (Q5) from 5.1% (2007-08) to 8.4% (2018-19). The OOP CI increased from 0.028 to 0.051, while the SII and RII increased from 0.89 to 1.32 and 1.18 to 1.36, respectively. Decomposition analysis showed that household size, composition, employment, and the province of residence explained much of the socioeconomic inequality in CHEs. Conclusion: Poor households experience high CHE, disproportionately impacting larger families with children and elderly members. Policymakers should implement targeted financial protection strategies to safeguard vulnerable households from the impoverishing effects of healthcare expenses.
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