Are health care payments in Albania catastrophic? Evidence form ALSMS 2002, 2005 and 2008

Sonila Tomini () and Truman G. Packard ()
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Sonila Tomini: Maastricht Graduate School of Governance, Maastricht University
Truman G. Packard: Europe and Central Asia Human Development Sector, The World Bank

No 2011-019, MERIT Working Papers from United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT)

Abstract: The absent or poorly functioning risk pooling mechanisms and high amounts of out-of-pocket payments for health care expose households to financial risks associated with major illnesses or accidents. The aim of this paper is to analyse the extent to which out-of-pocket health spending impoverish the households in Albania. The study augments the existing evidence by analysing the dynamics of such payments over different years and the weight that informal payments have in the total out-of-pocket health spending. The data used in this study come from Albania Living Standard Measurement Survey (ALSMS) for 2002, 2005 and 2008. We measure headcount catastrophic payments using different thresholds and the decomposition of indicators by expenditure quintiles to understand better their effects. We find that out-of-pocket and informal payments have increased in real value throughout the years. Even though their catastrophic effect has gone down (due also to declining trends in absolute poverty), the effect for the poorest expenditure quintiles remains high. Out-of-pocket payments deepen the poverty headcount and also enlarge the poverty gap and again the effect is larger for the poorest quintiles. Future policy interventions should provide better protection mechanisms for the poor by providing exemption criteria or subsidised transport and should seek to address the widespread informal payments in the country.

Keywords: informal payments; out-of-pocket payments; health care expenditure; impoverishment; Albania LSMS; Albania; living standard; poverty (search for similar items in EconPapers)
JEL-codes: E26 I14 I15 I18 I32 I38 O17 (search for similar items in EconPapers)
Date: 2011
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Persistent link: https://EconPapers.repec.org/RePEc:unm:unumer:2011019

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