Factors related to excessive out-of-pocket expenditures among the ultra-poor after discontinuity of PBF

• Verfasst von: Beaugé, Yvonne [VerfasserIn]
• Verfasst von: Ridde, Valéry [VerfasserIn]
• Verfasst von: Bonnet, Emmanuel [VerfasserIn]
• Verfasst von: Souleymane, Sidibé [VerfasserIn]
• Verfasst von: Kuunibe, Naasegnibe [VerfasserIn]
• Verfasst von: De Allegri, Manuela [VerfasserIn]
• Titel: Factors related to excessive out-of-pocket expenditures among the ultra-poor after discontinuity of PBF
• Titelzusatz: a cross-sectional study in Burkina Faso
• Verf.angabe: Yvonne Beaugé, Valéry Ridde, Emmanuel Bonnet, Sidibé Souleymane, Naasegnibe Kuunibe and Manuela De Allegri
• Jahr: 2020
• Fussnoten: Gesehen am 02.02.2021
• Titel Quelle: Enthalten in: Health economics review
• Ort Quelle: Heidelberg : Springer, 2011
• Jahr Quelle: 2020
• Band/Heft Quelle: 10(2020) Artikel-Nummer 36, 11 Seiten
• ISSN Quelle: 2191-1991
• DOI: doi:10.1186/s13561-020-00293-w
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Out-of-pocket expenditure
• Sach-SW: Ultra-poor
• Sach-SW: Targeting
• Sach-SW: Performance-based financing
• Sach-SW: Burkina Faso
• Form-SW: Aufsatz in Zeitschrift
• K10plus-PPN: 1743890389
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background: Measuring progress towards financial risk protection for the poorest is essential within the framework of Universal Health Coverage. The study assessed the level of out-of-pocket expenditure and factors associated with excessive out-of-pocket expenditure among the ultra-poor who had been targeted and exempted within the context of the performance-based financing intervention in Burkina Faso. Ultra-poor were selected based on a community-based approach and provided with an exemption card allowing them to access healthcare services free of charge. Methods: We performed a descriptive analysis of the level of out-of-pocket expenditure on formal healthcare services using data from a cross-sectional study conducted in Diébougou district. Multivariate logistic regression was performed to investigate the factors related to excessive out-of-pocket expenditure among the ultra-poor. The analysis was restricted to individuals who reported formal health service utilisation for an illness-episode within the last six months. Excessive spending was defined as having expenditure greater than or equal to two times the median out-of-pocket expenditure. Results: Exemption card ownership was reported by 83.64% of the respondents. With an average of FCFA 23051.62 (USD 39.18), the ultra-poor had to supplement a significant amount of out-of-pocket expenditure to receive formal healthcare services at public health facilities which were supposed to be free. The probability of incurring excessive out-of-pocket expenditure was negatively associated with being female (β = − 2.072, p = 0.00, ME = − 0.324; p = 0.000) and having an exemption card (β = − 1.787, p = 0.025; ME = − 0.279, p = 0.014). Conclusions: User fee exemptions are associated with reduced out-of-pocket expenditure for the ultra-poor. Our results demonstrate the importance of free care and better implementation of existing exemption policies. The ultra-poor's elevated risk due to multi-morbidities and severity of illness need to be considered when allocating resources to better address existing inequalities and improve financial risk protection.