Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare

Shohei Okamoto (), Mizuki Sata, Megumi Rosenberg, Natsuko Nakagoshi, Kazuki Kamimura, Kohei Komamura, Erika Kobayashi, Junko Sano, Yuzuki Hirazawa, Tomonori Okamura and Hiroyasu Iso
Additional contact information
Shohei Okamoto: Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology
Mizuki Sata: Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
Megumi Rosenberg: World Health Organization Centre for Health Development
Natsuko Nakagoshi: Keio University School of Medicine
Kazuki Kamimura: Keio University
Kohei Komamura: Keio University
Erika Kobayashi: Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology
Junko Sano: Keio University
Yuzuki Hirazawa: Keio University
Tomonori Okamura: Keio University School of Medicine
Hiroyasu Iso: Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine

Health Economics Review, 2024, vol. 14, issue 1, 1-16

Abstract: Abstract Background Universal health coverage means that all people can access essential health services without incurring financial hardship. Even in countries with good service coverage and financial protection, the progress towards universal health coverage may decelerate or be limited with respect to the growing older population. This study investigates the incidence/prevalence, determinants, and consequences of catastrophic health expenditure (CHE) and unmet need for healthcare and assesses the potential heterogeneity between younger (≤ 64 years) and older people (65 years≤). Methods Utilising an annual nationally representative survey of Japanese aged 20 years and over, we estimated the incidence of CHE and unmet need for healthcare using disaggregated estimates by household members’ age (i.e. ≤64 years vs. 65 years≤) between 2004 and 2020. Using a fixed-effects model, we assessed the determinants of CHE and unmet need along with the consequences of CHE. We also assessed the heterogeneity by age. Results Households with older members were more likely to have their healthcare needs met but experienced CHE more so than households without older members. The financial consequences of CHE were heterogeneous by age, suggesting that households with older members responded to CHE by reducing food and social expenditures more so than households without older members reducing expenditure on education. Households without older members experienced an income decline in the year following the occurrence of CHE, while this was not found among households with older members. A U-shaped relationship was observed between age and the probability of experiencing unmet healthcare need. Conclusions Households with older members are more likely to experience CHE with different financial consequences compared to those with younger members. Unmet need for healthcare is more common among younger and older members than among their middle-aged counterparts. Different types and levels of health and financial support need to be incorporated into national health systems and social protection policies to meet the unique needs of individuals and households.

Keywords: Universal health coverage; UHC; Financial protection; Population ageing; Catastrophic health expenditure; Unmet need (search for similar items in EconPapers)
Date: 2024
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1186/s13561-023-00475-2 Abstract (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:hecrev:v:14:y:2024:i:1:d:10.1186_s13561-023-00475-2

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/13561

DOI: 10.1186/s13561-023-00475-2

Access Statistics for this article

Health Economics Review is currently edited by J. Matthias Graf von der Schulenburg

More articles in Health Economics Review from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().