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      Out- Of- Pocket health expenditure and household consumption patterns in Benin: Is there a crowding out effect?

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          Abstract

          Health shocks are common and have serious consequences for households in developing countries where health insurance is lacking. In this study, we examine whether out-of-pocket health expenditures crowd out household consumption of non-healthcare necessities, such as education items in Benin using a sample of 14,952 households from the global vulnerability and food security analysis survey. We estimated a system of conditional Engel curves with three stage least squared (3SLS) and seemingly unrelated regression (SURE) for seven categories of goods using the Quadratic Almost Ideal Demand System (QUAIDS) in the form of budget shares corresponding to proportions of total non-health expenditure. Findings show that out of pocket health expenditure leads households to spend more on health care that in fine crowd out expenditure in other necessity goods such as education item. These findings highlight the need for social protection programs to mitigate the impact of health shocks on vulnerable households in Benin.

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          Household catastrophic health expenditure: a multicountry analysis.

          Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. Yet catastrophic expenditure is not rare. We investigated the extent of catastrophic health expenditure as a first step to developing appropriate policy responses. We used a cross-country analysis design. Data from household surveys in 59 countries were used to explore, by regression analysis, variables associated with catastrophic health expenditure. We defined expenditure as being catastrophic if a household's financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met. The proportion of households facing catastrophic payments from out-of-pocket health expenses varied widely between countries. Catastrophic spending rates were highest in some countries in transition, and in certain Latin American countries. Three key preconditions for catastrophic payments were identified: the availability of health services requiring payment, low capacity to pay, and the lack of prepayment or health insurance. People, particularly in poor households, can be protected from catastrophic health expenditures by reducing a health system's reliance on out-of-pocket payments and providing more financial risk protection. Increase in the availability of health services is critical to improving health in poor countries, but this approach could raise the proportion of households facing catastrophic expenditure; risk protection policies would be especially important in this situation.
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            Social Determinants of Health

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              Income Risk, Coping Strategies, and Safety Nets

              S. Dercon (2002)

                Author and article information

                Contributors
                senoumod@gmail.com
                Journal
                Health Econ Rev
                Health Econ Rev
                Health Economics Review
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2191-1991
                27 March 2023
                27 March 2023
                2023
                : 13
                : 19
                Affiliations
                [1 ]GRID grid.412037.3, ISNI 0000 0001 0382 0205, University of Abomey Calavi, ; Calavi, Benin
                [2 ]GRID grid.474983.5, ISNI 0000 0004 0418 1654, African Economic Research Consortium, ; Nairobi, Kenya
                [3 ]Economics, African Centre of Excellence for Inequality Research, Cape Town, South Africa
                Author information
                http://orcid.org/0000-0002-9759-1307
                Article
                429
                10.1186/s13561-023-00429-8
                10041797
                36971878
                cc8f8fd0-3f65-462c-abff-2e26b8b3d1c7
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 4 October 2022
                : 8 March 2023
                Categories
                Research
                Custom metadata
                © The Author(s) 2023

                Economics of health & social care
                health shocks,consumption patterns,out of pocket,crowding out effect,sure,benin,o12 i13

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