Why the poor pay more: household curative expenditures in rural Sierra Leone
| العنوان: | Why the poor pay more: household curative expenditures in rural Sierra Leone |
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| المؤلفون: | Stephen J. Fabricant, Clifford W. Kamara, Anne Mills |
| المصدر: | The International Journal of Health Planning and Management. 14:179-199 |
| بيانات النشر: | Wiley, 1999. |
| سنة النشر: | 1999 |
| مصطلحات موضوعية: | Government, Economic growth, education.field_of_study, Equity (economics), business.industry, Health Policy, Population, Developing country, Prepayment of loan, Sierra leone, Health care, Economics, Cost sharing, Demographic economics, business, education, health care economics and organizations |
| الوصف: | This paper draws on data from Sierra Leone and secondary data from elsewhere to show that the rural poor can be disproportionately disadvantaged by user charges for health care paying a higher percentage of their incomes for health care than wealthier households. Cost sharing systems at primary care level should include exemptions for the poor but rarely succeed in consistently protecting them. The regressivity of health expenditures also results from lack of protection from the higher costs of less-frequently used expensive providers. In Sierra Leone the burden of curative treatment costs for all groups came mainly from private and nongovernmental organization providers. Proximity to facilities appeared a more important factor in their use than average prime levels. Even if a perfect exemption system existed at government primary care facilities it would not have had much overall effect because of their relatively small contribution to household health expenditures. The financial burden on households could be relieved by making basic health facilities more accessible and at hospital level using additional resources generated through improved efficiency and cross-subsidization to provide exemptions. Also pricing policy should take into account local economic conditions. Insurance/prepayment schemes covering the cost of hospitalization would come closer to an ideal solution but have been implemented in very few of the poorer countries. (authors) |
| تدمد: | 1099-1751 0749-6753 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::b19336162bcd99723bbf524905cd2c90 https://doi.org/10.1002/(sici)1099-1751(199907/09)14:3<179::aid-hpm548>3.0.co;2-n |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........b19336162bcd99723bbf524905cd2c90 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10991751 07496753 |
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