Financial access to health care for older people in Cambodia: 10-year trends (2004-14) and determinants of catastrophic health expenses
| Autor: | Bart Jacobs, Richard de Groot, Adélio Fernandes Antunes |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Male
Rural Population medicine.medical_specialty Economic growth Population Health Services Accessibility Out-of-pocket expenses Impoverishment 03 medical and health sciences Low-income country 0302 clinical medicine Indebtedness Surveys and Questionnaires Environmental health Health care medicine Humans Rural Non-communicable diseases 030212 general & internal medicine education Poverty Health policy Aged Social policy Aged 80 and over Finance education.field_of_study business.industry Research 030503 health policy & services Public health Health Policy Health services research Public Health Environmental and Occupational Health Chronic Disease Income Social assistance Female Catastrophic health expenses Health Expenditures Older people Cambodia 0305 other medical science business |
| Zdroj: | International Journal for Equity in Health |
| ISSN: | 1475-9276 |
| DOI: | 10.1186/s12939-016-0383-z |
| Popis: | Background Older people make up an increasing proportion of the population in low- and middle-income countries. This brings a number of challenges, as their health needs are greater than, and different from, those of younger people. In general, these health systems are not geared to address their needs, and traditional support systems tend to erode, potentially causing financial hardship when accessing health care. This paper provides an overview of older Cambodians’ financial access to health care over time, using nationally representative data to enable the formulation of appropriate responses. Methods Using data from three nationally representative household surveys from 2004, 2009 and 2014, we assess key indicators of financial access to health care for households with older people (aged 60 years or older), and compare these with households without older members. For 2014 data, the determinants of catastrophic health expenses at the 10 and 40 % threshold were determined for older people. Data was stratified by age and place of residence (urban/rural), and analysed using Stata statistical software. Sample weights were calibrated to reflect accurate population composition at the time of the survey. Monetary values for 2004 and 2009 were transformed into 2014 values using annual inflation rate figures. Results Care-seeking when sick among older people increased considerably from 2004 to 2014, irrespective of gender or place of residence. There were positive trends in the incidence of catastrophic and impoverishing healthcare expenses over the studied time periods. This was also the case for indebtedness. Rural households with older people were considerable more likely to suffer financial hardship due to health-related expenses than their urban equivalents. In 2014, older people spent 50 % more per month on health care than younger people. Determinants of catastrophic health expenditures among households with older people were residing in a rural area, and having a household member with an illness, especially a non-communicable disease. Conclusion In order to make health care more equitable for older people, efforts should be directed to rural areas. Interventions should include improving management of non-communicable diseases at the primary care level, together with a reconfiguration of social health protection schemes to increase the inclusion of older people. |
| Databáze: | OpenAIRE |
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