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Household catastrophic health expenditure: evidence from Georgia and its policy implications
Open accessAbstract
Background: To quantify extent of catastrophic household health expenditures, determine factors influencing it and estimate Fairness in Financial Contribution (FFC) index in Georgia to establish the baseline for expected reforms and contribute to the design and fine-tuning of the major reforms in health care financing initiated by the government mid-2007. Methods: The research is based on the nationally representative Health Care Utilization and Expenditure survey conducted during May-June 2007, prior to preparing for new phase of implementation for the health care financing reforms. Households' catastrophic health expenditures were estimated according to the methodology proposed by WHO – Ke Xu [1]. A logistic regression (logit) model was used to predict probability of catastrophic health expenditure occurrence. Results: In Georgia between 2000 and 2007 access to care for poor has improved slightly and the share of households facing catastrophic health expenditures have seemingly increased from 2.8% in 1999 to 11.7% in 2007. However, this variance may be associated with the methodological differences of the respective surveys from which the analysis were derived. The high level of the catastrophic health expenditure may be associated with the low share of prepayment in national health expenditure, adequate availability of services and a high level of poverty in the country. Major factors determining the financial catastrophe related to ill health were hospitalization, household members with chronic illness and poverty status of the household. The FFC for Georgia appears to have improved since 2004. Conclusion: Reducing the prevalence of catastrophic health expenditure is a policy objective of the government, which can be achieved by focusing on increased financial protection offered to poor and expanding government financed benefits for poor and chronically ill by including and expanding inpatient coverage and adding drug benefits. This policy recommendation may also be relevant for other Low and Middle Income countries with similar levels of out of pocket payments and catastrophic health expenditures.
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“The incidence of catastrophic health expenditure we found in sub-Saharan Africa was lower than in China in the last decade,139 but higher than in Europe,140–142 Asia,134,143,144 and South America,145,146 irrespective of the definition used.”
From Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis (2022) · cites this paper as [141]
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Metadata
- Authors
- Gotsadze, G., Zoidze, A., & Rukhadze, N.
- Affiliations
- Curatio International Foundation (GE)
- Corresponding author
- Rukhadze, Natia
- ORCID
- Gotsadze, George
- Venue
- BMC Health Services Research
- Published
- 2009-04-28
- Volume
- 9
- Issue
- 1
- Pages
- 69-69
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC2695816
- OpenAlex
- W2051202685
- Cited by
- 169
- References
- 19
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 15 · 2021: 17 · 2020: 14 · 2019: 15 · 2018: 11 · 2017: 10 · 2016: 9 · 2015: 11 · 2014: 24 · 2013: 9 · 2012: 5
- FWCI
- 8.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Global Health Care Issues
- Keywords
- catastrophic health expenditure, household health expenditure, health financing reform, out-of-pocket costs, financial protection, poverty, chronic disease, hospitalization, drug benefits, Georgia
- MeSH terms
- Catastrophic Illness, Health Expenditures, Family Characteristics, Georgia (Republic), Health Services, Health Services Accessibility, Health Services Research, Health Surveys, Humans, Poverty Areas, Surveys and Questionnaires, Logistic Models, Health Care Reform
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