BACKGROUND We assessed change in household catastrophic health care expenditures (CHE) and inequality in facing such expenditures in south-west Tehran. METHODS A cluster-sampled survey was conducted in 2003 using the World Health Survey questionnaire. We repeated the survey on the same sample in 2008 (635 and 603 households, respectively). We estimated the proportion of households facing CHE ...

BACKGROUND Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting...

One of the main challenges in the implementation of health care reform in developing countries of India has been the development of catastrophic household expenditure on health care. This papers aims at contributing to the examination of the content, measurement and policy implications of health care reform tackling catastrophic risks in one of the oldest city of Odisha that is Cuttack. We unde...

BACKGROUND Many health systems in Africa are funded primarily through out-of-pocket payments. Out-of-pocket payments prevent people from seeking care, can result to catastrophic health spending and lead to impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and the effect of health spending on na...

Background and purpose: In 2000 World Health Organization (WHO) has announced the fairness of financial contribution to health care costs, as one of the three goals of health systems. However, conducted studies in Iran reflect the dire situation in the context of health equity in terms of financing health care costs. The aim of the present study is to determine the disparities in health expendi...

BACKGROUND Equity of access to healthcare remains a major challenge with families continuing to face financial and non-financial barriers to services. Lack of education has been shown to be a key risk factor for 'catastrophic' health expenditure (CHE), in many countries including India. Consequently, ways to address the education divide need to be explored. We aimed to assess whether the innova...

BACKGROUND The social health insurance coverage is relatively high in Mongolia; however, escalation of out-of-pocket payments for health care, which reached 41 % of the total health expenditure in 2011, is a policy concern. The aim of this study is to analyse the incidence of catastrophic health expenditures and to measure the rate of impoverishment from health care payments under the social he...

BACKGROUND Although numerous studies examine catastrophic health expenditures (CHE) worldwide, most focus on whole populations rather than specific vulnerable groups. This study analyzes the extent, associated factors and inequality of CHE in elderly household with chronic disease patients in China. METHODS Data were obtained from a nationally representative elderly household survey-the China...

Background: Families are willing to spend their entire lives improving their children due to emotional attachments, which, in turn, increases their exposure to catastrophic health expenditures (CHEs). The present study aimed to estimate the level of exposure to CHEs and its determinants among households with pediatric cancer and oncology disorders. Materials and Methods: This cross-sectional s...

The article by Kent Ranson on the experience of the Self Employed Women’s Association’s (SEWA) Medical Insurance Fund in Gujarat, on pp. 613–621 of this issue of the Bulletin, focuses on catastrophic health care expenditure and thereby underlines the importance of ensuring that community financing schemes effectively protect households from impoverishment. It may well be a hope that such scheme...