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What contributes to out-of-pocket health expenditure in Cambodia's uncovered population? A distributional and decomposition analysis using survey data

Andrea Hannah Kaiser, Searivoth Vorn, Björn Ekman, Marlaina Ross, Sovathiro Mao, Sokunthea Koy, Pichenda Koeut and Jesper Sundewall

Social Science & Medicine, 2025, vol. 367, issue C

Abstract: Out-of-pocket health expenditures (OOPE) are an inefficient and inequitable means of health financing. Identifying the factors driving these expenditures is crucial to design effective prepayment schemes. This study uses Cambodia—a country with high OOPE and prevalent informal employment—as a case study to analyse the relative contributions of healthcare, health, and social factors to OOPE and the OOPE budget share (OOPE as a proportion of total annual household expenditure) across different points in their distribution.

Keywords: Financial protection; Out-of-pocket health expenditure; Out-of-pocket budget share; Unconditional quantile regression; Shapley decomposition; Relative importance; Low- and middle-income countries (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.117783

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