Paying Out of Pocket for Healthcare in Bangladesh - A Burden on Poor?

Out-of-pocket (OOP) expenditures for healthcare continue to be the most significant means of healthcare issue in the developing world and constitute a large share of their living financial plan (1, 2). The healthcare expenditures are largely unpredictable and usually have a negative impact on the poor households, while large expenditures have catastrophic impacts on household welfare. A sudden serious feature of the illness deceits in the critical susceptibility of the poor to an unexpected and unforeseen healthcare related vulnerabilities, increased indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards (3). A household that has the misfortune to succumb to illness and whose spending pattern is disrupted suffers a further welfare loss (2). The magnitude of this welfare loss will depend upon the living standards of that particular household. A well-off household can finance medical expenses from savings, or by reducing on luxury stuffs of consumption. However , a less well-off household is bound to cut back on daily necessities and could be placed into further shortage for living budgets (1). Impulsive healthcare expenditures can expose households to a considerable financial risk, while many forego such expenses thereby raising the level and extent of morbidity. Out-of-pocket healthcare expenditures of households in Bangladesh comprise 64.3% share of the total health expenditure and collectively spent approximately Taka 103.46 billion (US$1.49 billion) in yearly on health (4). High OOP expenditure in purchasing pharmaceuticals is the most distinctive feature in Bangladesh. Nearly 62% of the healthcare expenditure is on purchasing drugs and medical consultations (3). The high proportion of expenditure on drug reflects a high level of self-treatment and self-medication and in terms of share of household medical expenditure is diagnostic and imaging, which is about 10.6% (3). Households also spend a significant portion of its income on transportation is about 6.2% related to healthcare services and facilities (i.e. ambu-lance/car rental). It is observed that a household, on an average, spends 7.5% of its total income for and the poorest 20% spent approximately 13.5% of their income for purchasing health care (3). Thus, the intensity of catastrophic payments for various threshold levels reveals that approximately 29.2% of the households spend more than 5% of