Unravelling the socioeconomic gradient in the incidence of catastrophic health care expenditure a comment

The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between th...

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Published inHealth policy and planning Vol. 33; no. 5; pp. 699 - 701
Main Authors Joe, William, Rajpal, Sunil
Format Journal Article
LanguageEnglish
Published England Oxford University Press 01.06.2018
Oxford Publishing Limited (England)
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Abstract The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between the disciplines in the way trials are used, how they are conducted and how results from trials are reported and disseminated. We hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions. La prueba controlada aleatorizada es comúnmente usada por epidemiólogos y economistas para probar la efectividad de las intervenciones de salud pública. Sin embargo, hemos notado diferencias en la práctica entre las dos disciplinas. En este artículo, proponemos que hay algunas diferencias subyacentes entre las disciplinas en la forma en que se usan las pruebas, la forma en que se llevan a cabo y cómo los resultados de las pruebas son presentados y difundidos. Nuestra hipótesis es que la salud pública basada en la evidencia podría reforzarse mediante la comprensión de estas diferencias, entendiendo las mejores prácticas en ambas disciplinas y rompiendo las barreras de comunicación entre economistas y epidemiólogos que llevan a cabo las pruebas de intervenciones de salud pública.
AbstractList The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between the disciplines in the way trials are used, how they are conducted and how results from trials are reported and disseminated. We hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions. La prueba controlada aleatorizada es comúnmente usada por epidemiólogos y economistas para probar la efectividad de las intervenciones de salud pública. Sin embargo, hemos notado diferencias en la práctica entre las dos disciplinas. En este artículo, proponemos que hay algunas diferencias subyacentes entre las disciplinas en la forma en que se usan las pruebas, la forma en que se llevan a cabo y cómo los resultados de las pruebas son presentados y difundidos. Nuestra hipótesis es que la salud pública basada en la evidencia podría reforzarse mediante la comprensión de estas diferencias, entendiendo las mejores prácticas en ambas disciplinas y rompiendo las barreras de comunicación entre economistas y epidemiólogos que llevan a cabo las pruebas de intervenciones de salud pública.
In a recent article, Khan et al. (2017) employed two approaches to estimate the incidence of catastrophic out of pocket health care expenditure (CHE) in Bangladesh. Using one of the approaches, the authors find that 14.2% of households incur CHE at 10% threshold-level. Further, a negative concentration index (CI) value of −0.064 suggests that the CHE is concentrated among poor households. These results, however, contrast with previous evidence suggesting a pro-rich bias of CHE in Bangladesh (Khan et al. 2017; Van Doorslaer et al. 2007). In fact, a similar pro-rich bias is observed in India, Indonesia, Malaysia, Nepal and Philippines (Ghosh 2011; Van Doorslaer et al. 2007). Since high out-of-pocket CHE (OOP) is an important policy concern, we draw attention towards such contrasting socioeconomic gradients and suggest a way forward.
Author Rajpal, Sunil
Joe, William
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Cites_doi 10.1093/heapol/czx048
10.2307/1905382
10.1002/hec.776
10.1377/hlthaff.5.4.138
10.1596/0-8018-5254-4
10.1002/hec.1209
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Snippet The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have...
In a recent article, Khan et al. (2017) employed two approaches to estimate the incidence of catastrophic out of pocket health care expenditure (CHE) in...
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SubjectTerms Bangladesh
Bias
Catastrophic Illness
COMMENTARIES
Expenditures
Health administration
Health care
Health care expenditures
Health Expenditures
Health services
Households
Humans
Incidence
Poverty
Socioeconomic factors
Socioeconomics
Universal Health Insurance
Subtitle a comment
Title Unravelling the socioeconomic gradient in the incidence of catastrophic health care expenditure
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