A spatial analysis of out-of-pocket payments for healthcare in Malawi
Abstract Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic...
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| Veröffentlicht in: | Health policy and planning 2022-01, Vol.37 (1), p.65-72 |
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| creator | Mwale, Martin Limbikani Mchenga, Martina Chirwa, Gowokani Chijere |
| description | Abstract
Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic regions due to unequal demand, supply and prices of healthcare services. In this paper, we investigate the existence of geographical correlations in OOP health expenditures by employing a spatial Durbin model on data from 778 clusters obtained from the 2016 Malawi’s Integrated Household Survey. Results reveal that Malawian communities face geographical spillovers of OOP health expenditures. Furthermore, we find that factors including household size, education and geographical location are important drivers of the OOP health expenditure’s spatial dependency. The paper calls for policy in low-income countries to improve the quality and quantity of healthcare services in both OOP hotspots and their neighbouring communities. |
| doi_str_mv | 10.1093/heapol/czab090 |
| format | Article |
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Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic regions due to unequal demand, supply and prices of healthcare services. In this paper, we investigate the existence of geographical correlations in OOP health expenditures by employing a spatial Durbin model on data from 778 clusters obtained from the 2016 Malawi’s Integrated Household Survey. Results reveal that Malawian communities face geographical spillovers of OOP health expenditures. Furthermore, we find that factors including household size, education and geographical location are important drivers of the OOP health expenditure’s spatial dependency. The paper calls for policy in low-income countries to improve the quality and quantity of healthcare services in both OOP hotspots and their neighbouring communities.</description><identifier>ISSN: 1460-2237</identifier><identifier>ISSN: 0268-1080</identifier><identifier>EISSN: 1460-2237</identifier><identifier>DOI: 10.1093/heapol/czab090</identifier><identifier>PMID: 34343268</identifier><language>eng</language><publisher>UK: Oxford University Press</publisher><subject>Delivery of Health Care ; Dependency ; Expenditures ; Financing, Personal ; Geographical distribution ; Geographical locations ; Health care ; Health care expenditures ; Health Expenditures ; Health services ; Household size ; Households ; Humans ; Income ; Malawi ; Payments ; Personal expenditure ; Prices ; Regions ; Spatial Analysis ; Supply & demand</subject><ispartof>Health policy and planning, 2022-01, Vol.37 (1), p.65-72</ispartof><rights>The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-35040bd9991398be7350834395a434a86e841cb5b088c17545900c526d76326d3</citedby><cites>FETCH-LOGICAL-c390t-35040bd9991398be7350834395a434a86e841cb5b088c17545900c526d76326d3</cites><orcidid>0000-0003-0199-779X ; 0000-0003-1809-7210 ; 0000-0001-9165-7320</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1604,27866,27924,27925,30999</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/heapol/czab090$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34343268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mwale, Martin Limbikani</creatorcontrib><creatorcontrib>Mchenga, Martina</creatorcontrib><creatorcontrib>Chirwa, Gowokani Chijere</creatorcontrib><title>A spatial analysis of out-of-pocket payments for healthcare in Malawi</title><title>Health policy and planning</title><addtitle>Health Policy Plan</addtitle><description>Abstract
Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic regions due to unequal demand, supply and prices of healthcare services. In this paper, we investigate the existence of geographical correlations in OOP health expenditures by employing a spatial Durbin model on data from 778 clusters obtained from the 2016 Malawi’s Integrated Household Survey. Results reveal that Malawian communities face geographical spillovers of OOP health expenditures. Furthermore, we find that factors including household size, education and geographical location are important drivers of the OOP health expenditure’s spatial dependency. The paper calls for policy in low-income countries to improve the quality and quantity of healthcare services in both OOP hotspots and their neighbouring communities.</description><subject>Delivery of Health Care</subject><subject>Dependency</subject><subject>Expenditures</subject><subject>Financing, Personal</subject><subject>Geographical distribution</subject><subject>Geographical locations</subject><subject>Health care</subject><subject>Health care expenditures</subject><subject>Health Expenditures</subject><subject>Health services</subject><subject>Household size</subject><subject>Households</subject><subject>Humans</subject><subject>Income</subject><subject>Malawi</subject><subject>Payments</subject><subject>Personal expenditure</subject><subject>Prices</subject><subject>Regions</subject><subject>Spatial Analysis</subject><subject>Supply & demand</subject><issn>1460-2237</issn><issn>0268-1080</issn><issn>1460-2237</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqFkM9LwzAcxYMobk6vHiXgRQ_dvmmSNjmOMX-A4kXPJU1T1pk2tWmR-dcb6RTxIu-Q8OWT9315CJ0TmBOQdLExqnV2oT9UDhIO0JSwBKI4punhr_sEnXi_BSCMMX6MJpQFxYmYovUS-1b1lbJYNcrufOWxK7Eb-siVUev0q-lxq3a1aXqPS9fhsNH2G606g6sGPyqr3qtTdFQq683Z_pyhl5v18-oueni6vV8tHyJNJfQR5cAgL6SUhEqRmzQMREgiuQqBlEiMYETnPAchNEk54xJA8zgp0iTELegMXY2-befeBuP7rK68NtaqxrjBZzHnAoSkKQvo5R9064YufDFQSZBMAeJAzUdKd877zpRZ21W16nYZgeyr4GwsONsXHB5c7G2HvDbFD_7daACuR8AN7X9mn-RWg9Q</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Mwale, Martin Limbikani</creator><creator>Mchenga, Martina</creator><creator>Chirwa, Gowokani Chijere</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>8BJ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0199-779X</orcidid><orcidid>https://orcid.org/0000-0003-1809-7210</orcidid><orcidid>https://orcid.org/0000-0001-9165-7320</orcidid></search><sort><creationdate>20220101</creationdate><title>A spatial analysis of out-of-pocket payments for healthcare in Malawi</title><author>Mwale, Martin Limbikani ; 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Out-of-pocket (OOP) expenditures on health remain high in many low- and middle-income countries despite policy efforts aiming to reduce these health costs by targeting their hotspots. Hotspot targeting remains inadequate, particularly where the OOP expenditures are related across geographic regions due to unequal demand, supply and prices of healthcare services. In this paper, we investigate the existence of geographical correlations in OOP health expenditures by employing a spatial Durbin model on data from 778 clusters obtained from the 2016 Malawi’s Integrated Household Survey. Results reveal that Malawian communities face geographical spillovers of OOP health expenditures. Furthermore, we find that factors including household size, education and geographical location are important drivers of the OOP health expenditure’s spatial dependency. The paper calls for policy in low-income countries to improve the quality and quantity of healthcare services in both OOP hotspots and their neighbouring communities.</abstract><cop>UK</cop><pub>Oxford University Press</pub><pmid>34343268</pmid><doi>10.1093/heapol/czab090</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0199-779X</orcidid><orcidid>https://orcid.org/0000-0003-1809-7210</orcidid><orcidid>https://orcid.org/0000-0001-9165-7320</orcidid></addata></record> |
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| source | Oxford Journals Open Access Collection |
| subjects | Delivery of Health Care Dependency Expenditures Financing, Personal Geographical distribution Geographical locations Health care Health care expenditures Health Expenditures Health services Household size Households Humans Income Malawi Payments Personal expenditure Prices Regions Spatial Analysis Supply & demand |
| title | A spatial analysis of out-of-pocket payments for healthcare in Malawi |
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