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Equity in health care financing in Portugal: findings from the Household Budget Survey 2010/2011

  • Carlota Quintal (a1) and José Lopes (a2)
Abstract
Abstract

Equity in health care financing is recognised as a main goal in health policy. It implies that payments should be linked to capacity to pay and that households should be protected against catastrophic health expenditure (CHE). The risk of CHE is inversely related to the share of out-of-pocket payments (OOP) in total health expenditure. In Portugal, OOP represented 26% of total health expenditure in 2010 [one of the highest among Organisation for Economic Co-operation and Development (OECD) countries]. This study aims to identify the proportion of households with CHE in Portugal and the household factors associated with this outcome. Additionally, progressivity indices are calculated for OOP and private health insurance. Data were taken from the Portuguese Household Budget Survey 2010/2011. The prevalence of CHE is 2.1%, which is high for a developed country with a universal National Health Service. The main factor associated with CHE is the presence of at least one elderly person in households (when the risk quadruples). Payments are particularly regressive for medicines. Regarding the results by regions, the Kakwani index for total OOP is larger (negative) for the Centre and lower, not significant, for the Azores. Payments for voluntary health insurance are progressive.

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Corresponding author
*Correspondence to: Carlota Quintal, Faculty of Economics, University of Coimbra, Avenida Dias da Silva 165, 3004–512 Coimbra, Portugal. Email: qcarlota@fe.uc.pt
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J. Adda and V. Lechene (2013), ‘Health selection and the effect of smoking on mortality’, The Scandinavian Journal of Economics, 115: 902931.

D. Aristei and L. Pieroni (2009), ‘Addiction, social interactions and gender differences in cigarette consumption’, Empirica, 36: 245272.

J. Arsenijevic , M. Pavlova and W. Groot (2013), ‘Measuring the catastrophic and impoverishing effect of household health care spending in Serbia’, Social Science & Medicine, 78: 1725.

P. Baji , M. Pavlova , L. Gulácsi and W. Groot (2012), ‘Changes in equity in out-of-pocket payments during the period of health care reforms: evidence from Hungary’, International Journal for Equity in Health, 11: 36.

P. Barros (2012), ‘Health policy reform in tough times: the case of Portugal’, Health Policy, 106: 1722.

P. Barros , R. Cristóvão and P. Gomes (2013), ‘Chapter 13: Portugal’, in L. Siciliani, M. Borowitz and V. Moran (eds), Waiting Time Policies in the Health Sector: What Works?, OECD Health Policy Studies, Paris: OECD Publishing.

I. Gupta and J. William (2013), ‘Refining estimates of catastrophic healthcare expenditure: an application in the Indian context’, International Journal of Health Care Finance and Economics, 13: 157172.

N. Kakwani , A. Wagstaff and E. van Doorslaer (1997), ‘Socioeconomics inequalities in health: measurement, computation and statistical inference’, Journal of Econometrics, 77: 87103.

C. Kronenberg and P. P. Barros (2014), ‘Catastrophic healthcare expenditure – drivers and protection: the Portuguese case’, Health Policy, 115(1): 4451.

C. B. Lakhdar , G. Cauchie , N. J. Vaillant and F.-C. Wolff (2012), ‘The role of family incomes in cigarette smoking: evidence from French students’, Social Science & Medicine, 74: 18641873.

J. L. Lara and F. R. Gómez (2011), ‘Determining factors of catastrophic health spending in Bogota, Colombia’, International Journal of Health Care Finance and Economics, 11: 83100.

H. O. Narci , I. Sahin and H. H. Yildirim (2015), ‘Financial catastrophe and poverty impacts of out-of-pocket health payments in Turkey’, The European Journal of Health Economics, 16: 255270.

A. Wagstaff and E. van Doorslaer (1992), ‘Equity in the finance of health care: some international comparisons’, Journal of Health Economics, 11: 361387.

A. Wagstaff , E. van Doorslaer , H. van der Burg , S. Calonge, T. Christiansen, G. Citoni, U.-G. Gerdtham, M. Gerfin, L. Gross, U. Hakinnen, P. Johnson, J. John, J. Klavus, C. Lauchaud, J. Lauritsen, R. Leu, B. Nolan, E. Perán, J. Pereira, C. Propper, F. Puffer, L. Rochaix, M. Rodríguez, M. Schellhorn, G. Sundberg and O. Winkelhake (1999), ‘Equity in the finance of health care: some further international comparisons’, Journal of Health Economics, 18: 263290.

K. Xu , D. B. Evans , K. Kawabata , R. Zeramdini , J. Klavus and C. J. Murray (2003), ‘Household catastrophic health expenditure: a multicountry analysis’, Lancet, 362(9378): 111117.

K. Xu , D. B. Evans , G. Carrin , A. M. Aguilar , P. Musgrove and T. Evans (2007), ‘Protecting households from catastrophic health spending’, Health Affairs, 26(4): 972983.

K. Xu , D. Evans , P. Kadama , J. Nabyonga , P. O. Ogwal , P. Nabukhonzo and A. M. Aguilar (2006), ‘Understanding the impact of eliminating user fees: utilization and catastrophic health expenditures in Uganda’, Social Science & Medicine, 62: 866876.

M. S. Yardim , N. Cilingiroglu and N. Yardim (2010), ‘Catastrophic health expenditure and impoverishment in Turkey’, Health Policy, 94: 2633.

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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
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