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 in | Health policy and planning Vol. 33; no. 5; pp. 699 - 701 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
England
Oxford University Press
01.06.2018
Oxford Publishing Limited (England) |
Subjects | |
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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. |
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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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References | 29617996 - Health Policy Plan. 2018 Jun 1;33(5):697-698 28575415 - Health Policy Plan. 2017 Oct 1;32(8):1102-1110 NSSO ( key 20180514080545_czy026-B6) 2015 Wagstaff ( key 20180514080545_czy026-B9) 2008 Berki ( key 20180514080545_czy026-B1) 1986; 5 Khan ( key 20180514080545_czy026-B5) 2017; 32 van Doorslaer ( key 20180514080545_czy026-B8) 2007; 16 Wagstaff ( key 20180514080545_czy026-B10) 2003; 12 Deaton ( key 20180514080545_czy026-B2) 1997 Wyszewianski ( key 20180514080545_czy026-B11) 1986; 23 Houthakker ( key 20180514080545_czy026-B4) 1957; 25 O’Donnell ( key 20180514080545_czy026-B7) 2008 Ghosh ( key 20180514080545_czy026-B3) 2011; 46 |
References_xml | – volume: 32 start-page: 1102 year: 2017 ident: key 20180514080545_czy026-B5 article-title: Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh—an estimation of financial risk protection of universal health coverage publication-title: Health Policy and Planning doi: 10.1093/heapol/czx048 contributor: fullname: Khan – year: 2008 ident: key 20180514080545_czy026-B9 contributor: fullname: Wagstaff – volume: 25 start-page: 532 year: 1957 ident: key 20180514080545_czy026-B4 article-title: An international comparison of household expenditure patterns, commemorating the centenary of Engel's law publication-title: Econometrica doi: 10.2307/1905382 contributor: fullname: Houthakker – volume: 12 start-page: 921 year: 2003 ident: key 20180514080545_czy026-B10 article-title: Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998 publication-title: Health Economics doi: 10.1002/hec.776 contributor: fullname: Wagstaff – volume: 46 start-page: 47 year: 2011 ident: key 20180514080545_czy026-B3 article-title: Catastrophic payments and impoverishment due to out of pocket health spending publication-title: Economic and Political Weekly contributor: fullname: Ghosh – volume: 23 start-page: 382 year: 1986 ident: key 20180514080545_czy026-B11 article-title: Financially catastrophic and high-cost cases: definitions, distinctions, and their implications for policy formulation publication-title: Inquiry contributor: fullname: Wyszewianski – volume: 5 start-page: 138 year: 1986 ident: key 20180514080545_czy026-B1 article-title: A look at catastrophic medical expenses and the poor publication-title: Health Affairs doi: 10.1377/hlthaff.5.4.138 contributor: fullname: Berki – volume-title: The Analysis of Household Surveys: A Microeconometric Approach to Development Policy year: 1997 ident: key 20180514080545_czy026-B2 doi: 10.1596/0-8018-5254-4 contributor: fullname: Deaton – year: 2015 ident: key 20180514080545_czy026-B6 contributor: fullname: NSSO – volume: 16 start-page: 1159 year: 2007 ident: key 20180514080545_czy026-B8 article-title: Catastrophic payments for health care in Asia publication-title: Health Economics doi: 10.1002/hec.1209 contributor: fullname: van Doorslaer – volume-title: Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation year: 2008 ident: key 20180514080545_czy026-B7 contributor: fullname: O’Donnell |
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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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