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-...

Full description

Bibliographic Details
Main Authors: James Akazili, Diane McIntyre, Edmund W. Kanmiki, John Gyapong, Abraham Oduro, Osman Sankoh, John E. Ataguba
Format: Article
Language:English
Published: Taylor & Francis Group 2017-01-01
Series:Global Health Action
Subjects:
Online Access:http://dx.doi.org/10.1080/16549716.2017.1289735
id doaj-e4c5d6525cf94d8a97e4af2bde7416db
record_format Article
spelling 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
work_keys_str_mv AT jamesakazili assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT dianemcintyre assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT edmundwkanmiki assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT johngyapong assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT abrahamoduro assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT osmansankoh assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
AT johneataguba assessingthecatastrophiceffectsofoutofpockethealthcarepaymentspriortotheuptakeofanationwidehealthinsuranceschemeinghana
_version_ 1716751710612881408