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Health Policy. 2011 May;100(2-3):151-8. doi: 10.1016/j.healthpol.2010.08.004. Epub 2010 Sep 9.

Access to care and medicines, burden of health care expenditures, and risk protection: results from the World Health Survey.

Author information

1
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. awagner@hms.harvard.edu

Abstract

OBJECTIVES:

We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden.

METHODS:

We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries.

RESULTS:

Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden.

CONCLUSION:

To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.

PMID:
20828854
DOI:
10.1016/j.healthpol.2010.08.004
[Indexed for MEDLINE]

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