Explaining the incidence of catastrophic （解释了灾难性的发病率）.pdf

EQUITAP Project: Working Paper #5 Explaining the incidence of catastrophic expenditures on health care: Comparative evidence from Asia Owen O’Donnell University of Macedonia, Greece Eddy van Doorslaer Erasmus University, the Netherlands Ravi P. Rannan-Eliya Institute for Health Policy , Sri Lanka Aparnaa Somanathan Institute for Health Policy , Sri Lanka Charu C. Garg Institute for Human Development, India Piya Hanvoravongchai International Health Policy Programme, Thailand Mohammed N. Huq Data International Ltd., Bangladesh Anup Karan Institute for Human Development, India Gabriel M. Leung University of Hong Kong, Hong Kong SAR Keith Tin University of Hong Kong, Hong Kong SAR Chitpranee Vasavid International Health Policy Programme, Thailand June 2005 Abstract Out-of-pocket (OOP) financing of health care leaves households exposed to the risk of unforeseen expenditures that absorb a large share of the household budget. We explain variation in the incidence of catastrophic medical expenditures across households in six Asian countries/territories. Except in India and Sri Lanka, larger households are more likely to incur catastrophic payments. The incidence is higher in rural areas and lower among households with a sanitary toilet and safe drinking water. Household total consumption is positively correlated with the incidence of catastrophic payments. We distinguish between effects through the mean and the variance of the OOP budget share by