The Determinants Out-of-Pocket Healthcare Expenditure in Bangladesh: Evidence from Household Income and Expenditure Survey-2010

Abstract

Like many low- and middle income countries, out-of-pocket payment (OOPP) is the most common healthcare financing mechanism in Bangladesh. Higher and unpredictable health payments can expose households to substantial financial risk along with, at their most extreme, can result in economic impoverishment. Health policy-makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. This study intends to examine the factors that are mostly influencing out-of-pocket payments healthcare in Bangladesh. A total of 10,705 populations who spent for receiving any type of healthcare services were analyzed from Bangladesh Household Income and Expenditure Survey data, 2010. We used a multiple regression model for the determinants of OOPP using Ordinary Least Square (OLS) considering socio-economic, demographic, social financial security as well as health-related indicators. Adjusted findings showed that, household characteristics like unsafe water, unhygienic toilet and household belonging to urban community were significantly associated with OOP payments. The other significant factors were household income, age, sex, informal healthcare. Finding can help for the decision-makers by stating OOPP determinants, discussing the mechanism causing them and thus making them into account to adapt OOP relevant regulations which highlights the emphasis to develop financial protection mechanisms in Bangladesh. Government should consider enhancing resources of healthcare policy. Parallel to government, spending other prudent and sustainable risk-pooling mechanism can help reducing intensity of OOP payments.