Pattern and Correlates of Out-of-Pocket Payment Among Older People in Bangladesh

Abstract

AbstractIn low- and middle-income countries, including Bangladesh, most older people neither receive pensions nor have public or private health insurance. In Bangladesh, health care financing is highly inequitable due to the high share of out-of-pocket (OOP) payments for health. This disproportionately impacts the health of older people from low-income households who cannot afford to spend on health care. This OOP expenditure burden among older people could impact their morbidity outcomes and life expectancy in the absence of pensions and other social protective measures. However, there is little evidence on out-of-pocket health expenditure among older people in Bangladesh, mainly due to the lack of data exclusively focusing on older people. To fill this gap, the paper first carried out a literature review on out-of-pocket payments for health among older people in Bangladesh. In addition, using the 16th round of the Household Income and Expenditure Survey (HIES) 2016–2017, OOP among older people in Bangladesh was calculated. Older people in this study are defined as adults aged 60 and above. For comparative purposes, the analysis also included younger people in our analysis. HEIS 2016 interviewed nearly 186,054 individuals, including 15,268 older people aged 60 and above (8.2% of the sample). Our results showed that OOP increased with age. The increase was highest for age groups 40–49 and 50–59 compared to younger people.KeywordsOut-of-pocket paymentsBangladeshHealth careOlder people