An alternative framework for analyzing financial protection in health

• Published in: PLoS medicine Vol. 9; no. 8; p. e1001294
• Main Author: Ruger, Jennifer Prah
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.08.2012; Public Library of Science (PLoS)
• Subjects: Cost of Illness; Economic aspects; Economic conditions; Family Characteristics; Financing, Personal - economics; Health care expenditures; Health care policy; Health insurance; Healthcare Financing; Households; Humans; Insurance, Health - economics; Medical care; Medicine; Policy Forum; Science Policy; Studies; United States; United States; Cost of Illness; Family Characteristics; Healthcare Financing; Humans; Insurance, Health; Financing, Personal
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1001294

Abbreviations: WHO, World Health Organization Summary Points * Inadequate financial protection in health increases people's vulnerability and diminishes well-being, exacerbating inequities and raising moral concerns. * Conventional indicators of financial protection such as catastrophic spending and impoverishing spending are too narrowly conceived and likely to underestimate the adverse effects of insufficient financial protection. * Limitations of conventional indicators include failure to capture cost barriers to access, differences in health care utilization by ability to pay, different degrees of financial protection and coverage, "informal" treatment payments, debt financing of health spending, reduced consumption of other household necessities, as well as indirect costs of illness and coping strategies. * A multidimensional financial protection profile can capture interrelated aspects of health expenditure, such as direct and indirect costs of illness, coping strategies used to meet costs, insurance status and utilization, household consumption patterns, and how health costs affect them. * With the data the profile yields, researchers can further study health costs' effects by poverty or income level and type of health treatment for a fuller, more comprehensive view of health cost burdens and their distribution. Concerns include the failure to capture the following: cost barriers to access [2],[13]-[15]; differences in health care utilization by ability to pay [16]; protection inadequacies for poor individuals [17]; measures of illness vulnerability, such as the number of chronic conditions [11]; degrees of financial protection and coverage (underinsurance) [16]; "informal" treatment payments [11]; debt or credit financing of health care expenditures [18]; and reduced consumption of other household necessities (e.g., food, education, or utilities).