Assessing the incidence of catastrophic health expenditure and impoverishment from out-of-pocket payments and their determinants in Bangladesh: evidence from the nationwide Household Income and Expenditure Survey 2016

  • Topic: Assessing the incidence of catastrophic health expenditure and impoverishment from out-of-pocket payments and their determinants in Bangladesh: evidence from the nationwide Household Income and Expenditure Survey 2016
  • Presenter: Dr. Sayem Ahmed, Oxford University of Clinical Research Unit (OUCRU) Vietnam
  • Time: 11:00 – Thursday, May 20th, 2021
  • Venue: Room B1- 1001, Campus B, 279 Nguyen Tri Phuong, District 10, Ho Chi Minh City
  • Language: English

Abstract

Out-of-pocket (OOP) payments for healthcare have been increasing steadily in Bangladesh, which deteriorates the financial risk protection of many households. We aimed to investigate the incidence of catastrophic health expenditure (CHE) and impoverishment from OOP payments and their determinants. We employed nationally representative Household Income and Expenditure Survey 2016 data with a sample of 46 076 households. A household that made OOP payments of >10% of its total or 40% of its non-food expenditure was considered to be facing CHE. We estimated the impoverishment using both national and international poverty lines. Multiple logistic models were employed to identify the determinants of CHE and impoverishment. The incidence of CHE was estimated as 24.6% and 10.9% using 10% of the total and 40% of nonfood expenditure as thresholds, respectively, and these were concentrated among the poor. About 4.5% of the population (8.61 million) fell into poverty during 2016. Utilization of private facilities, the presence of older people, chronic illness and geographical location were the main determinants of both CHE and impoverishment. The financial hardship due to OOP payments was high and it should be reduced by regulating the private health sector and covering the care of older people and chronic illness by prepayment-financing mechanisms.

About the presenter:

Sayem Ahmed is a health economist with extensive experience in public health issues in developing countries. He is working as a Health Economist at the Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine of the University of Oxford. He is currently based at Oxford University of Clinical Research Unit (OUCRU), a large-scale clinical and public health research unit in Vietnam with considerable support from the Welcome Trust. At OUCRU, he integrates economic evaluation in different clinical trials targeting infectious diseases and antimicrobial resistance.  He previously worked for Liverpool School of Tropical Medicine, World Health Organization, The World Bank and Mr. Ahmed completed his PhD in Health Economics from Karolinska Institute. He published widely in health economics, cost-analysis, out-of-pocket payments, health insurance and inequality in health. Mr. Ahmed was a member of the Bangladesh National Health Accounts Committee. He taught health economics at the Independent University of Bangladesh, Liverpool School of Tropical Medicine and Karolinska Institute.

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