Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana
Background: Financial risk protection against the cost of unforeseen healthcare has gained global attention in recent years. Although Ghana implemented a nationwide health insurance scheme with a goal of reducing financial barriers to accessing healthcare and addressing impoverishing effects of out-...
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doaj-e4c5d6525cf94d8a97e4af2bde7416db2020-11-24T21:12:03ZengTaylor & Francis GroupGlobal Health Action1654-97161654-98802017-01-0110110.1080/16549716.2017.12897351289735Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in GhanaJames Akazili0Diane McIntyre1Edmund W. Kanmiki2John Gyapong3Abraham Oduro4Osman Sankoh5John E. Ataguba6Ghana Health ServiceUniversity of Cape TownGhana Health ServiceUniversity of Health and Allied SciencesGhana Health ServiceINDEPTH NetworkUniversity of Cape TownBackground: Financial risk protection against the cost of unforeseen healthcare has gained global attention in recent years. Although Ghana implemented a nationwide health insurance scheme with a goal of reducing financial barriers to accessing healthcare and addressing impoverishing effects of out-of-pocket (OOP) healthcare payments, there is a paucity of knowledge on the extent of financial catastrophe of such payments in Ghana. Thus, this paper assesses the catastrophic effect of OOP healthcare payments in Ghana. Methods: Ghana Living Standard Survey (GLSS 5) data collected in 2005/2006 are used in this study. Catastrophic effect of OOP healthcare payments is assessed using various thresholds of total household expenditure and non-food expenditure. Furthermore, four indices, namely the catastrophic payment headcount, catastrophic payment gap, weighted catastrophic payment headcount and weighted catastrophic payment gap, are defined and computed. Results: As at 2005/2006, it was estimated that 11.0% of households in Ghana spent over 5% of their total household expenditure on healthcare OOP. However, after adjusting for the concentration of such spending, it decreased to 10.9%. Also 10.7% of households spent more than 10% of their non-food consumption expenditure on OOP healthcare payments. Furthermore, about 2.6% of households are observed to have spent in excess of 20% of their total household income on healthcare OOP. With the exception of the 5% threshold of household expenditure, because the concentration indices of these expenditures are negative, the burden of such expenditures rests more on the poor. Conclusions: Significant levels of financial catastrophe existed in Ghana prior to the uptake of the national health insurance scheme. Poorer households were at a higher risk than the relatively well-off households. The results of this study present baseline assessment of the impact of Ghana’s health insurance policy on catastrophic healthcare payments. Thus, there is a need for continuous monitoring of financial catastrophe in the system to ensure that households are adequately protected.http://dx.doi.org/10.1080/16549716.2017.1289735Catastrophic paymentfinancial risk protectionout-of-pocket healthcare paymentsuniversal health coverageGhana |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
James Akazili Diane McIntyre Edmund W. Kanmiki John Gyapong Abraham Oduro Osman Sankoh John E. Ataguba |
spellingShingle |
James Akazili Diane McIntyre Edmund W. Kanmiki John Gyapong Abraham Oduro Osman Sankoh John E. Ataguba Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana Global Health Action Catastrophic payment financial risk protection out-of-pocket healthcare payments universal health coverage Ghana |
author_facet |
James Akazili Diane McIntyre Edmund W. Kanmiki John Gyapong Abraham Oduro Osman Sankoh John E. Ataguba |
author_sort |
James Akazili |
title |
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana |
title_short |
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana |
title_full |
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana |
title_fullStr |
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana |
title_full_unstemmed |
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana |
title_sort |
assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in ghana |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9716 1654-9880 |
publishDate |
2017-01-01 |
description |
Background: Financial risk protection against the cost of unforeseen healthcare has gained global attention in recent years. Although Ghana implemented a nationwide health insurance scheme with a goal of reducing financial barriers to accessing healthcare and addressing impoverishing effects of out-of-pocket (OOP) healthcare payments, there is a paucity of knowledge on the extent of financial catastrophe of such payments in Ghana. Thus, this paper assesses the catastrophic effect of OOP healthcare payments in Ghana. Methods: Ghana Living Standard Survey (GLSS 5) data collected in 2005/2006 are used in this study. Catastrophic effect of OOP healthcare payments is assessed using various thresholds of total household expenditure and non-food expenditure. Furthermore, four indices, namely the catastrophic payment headcount, catastrophic payment gap, weighted catastrophic payment headcount and weighted catastrophic payment gap, are defined and computed. Results: As at 2005/2006, it was estimated that 11.0% of households in Ghana spent over 5% of their total household expenditure on healthcare OOP. However, after adjusting for the concentration of such spending, it decreased to 10.9%. Also 10.7% of households spent more than 10% of their non-food consumption expenditure on OOP healthcare payments. Furthermore, about 2.6% of households are observed to have spent in excess of 20% of their total household income on healthcare OOP. With the exception of the 5% threshold of household expenditure, because the concentration indices of these expenditures are negative, the burden of such expenditures rests more on the poor. Conclusions: Significant levels of financial catastrophe existed in Ghana prior to the uptake of the national health insurance scheme. Poorer households were at a higher risk than the relatively well-off households. The results of this study present baseline assessment of the impact of Ghana’s health insurance policy on catastrophic healthcare payments. Thus, there is a need for continuous monitoring of financial catastrophe in the system to ensure that households are adequately protected. |
topic |
Catastrophic payment financial risk protection out-of-pocket healthcare payments universal health coverage Ghana |
url |
http://dx.doi.org/10.1080/16549716.2017.1289735 |
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