Payments towards health care, apart from securing access to health services, may also redistribute income. While such redistribution may be intended or unintended, policymakers are generally interested in the degree to which it occurs because of consequences for the distribution of goods and services other than health care. The rationale for being more concerned with the redistributive impact o...

New health technology comes on the market at a rapid pace and - sometimes - at a huge cost. Providing access to new health technology is a serious challenge for many countries with mandatory health insurance. This article analyses access to new health technology in Belgium and the Netherlands, using eight concrete examples as a starting point for comparing the two - neighbouring - countries. Co...

This paper assesses the extent of the financial burden due to out-of-pocket payments for health care incurred by people living with HIV (PLHIV) and the effect of this burden on their financial capacity. Data were collected in a cross-sectional survey of 353 PLHIV from three cities in Indonesia (Jakarta, Jogjakarta and Merauke). Respondents in Jakarta were sampled from one hospital and one non-g...

BACKGROUND As the drive towards universal coverage is gaining momentum globally, the need for assessing levels of financial health protection in countries, particularity the developing world, has increasingly become important. In Swaziland, the level of financial health protection is not clearly understood. OBJECTIVE To assess financial catastrophe and impoverishment from out-of-pocket paymen...

Out-of-pocket (OOP) expenditure on health care has significant implications for poverty in many developing countries. This paper aims to assess the differential impact of OOP expenditure and its components, such as expenditure on inpatient care, outpatient care and on drugs, across different income quintiles, between developed and less developed regions in India. It also attempts to measure pov...

Designing and implementing a health financing policy for universal coverage is relatively simple in principle but complex in practice. This issue of the Bulletin explores how it can be done, drawing lessons from several country experiences. Equity of access to health services of all types is key to universal coverage policy. High levels of out-of-pocket payments, including user fees, are still ...

BACKGROUND We estimated the personal costs to women found to have a breast problem (either breast cancer or benign breast disease) in terms of time spent, miles traveled, and cash payments made for detection, diagnosis, initial treatment, and follow-up. METHODS We analyzed data from personal interviews with 465 women from four communities in Florida. These women were randomly selected from th...

BACKGROUND Disability and chronic conditions both have an impact on health expenditures and although they are conceptually related, they present different dimensions of ill-health. Recent concepts of disability combine a biological understanding of impairment with the social dimension of activity limitation and resulted in the development of the Global Activity Limitation Indicator (GALI). This...

BACKGROUND The way a health system is financed affects the performance of its other functions of stewardship, input (or resource) creation and services provision, and ultimately, the achievement of health system goals of health improvement (or maintenance), responsiveness to people's non-medical expectations and fair financial contributions. OBJECTIVES To analyse the changes between 1998 and ...

OBJECTIVE To determine the nature, scope and effectiveness of interventions to reduce the household economic burden of illness or injury. METHODS We systematically reviewed reports published on or before 31 January 2014 that we found in the CENTRAL, CINAHL, Econlit, Embase, MEDLINE, PreMEDLINE and PsycINFO databases. We extracted data from prospective controlled trials and assessed the risk o...