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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
economics, econometrics and finance
Appraising financial protection in health: The case of Tunisia
International Journal of Health Care Finance and Economics, Volume 13, No. 1, Year 2013
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Description
Despite the remarkable progress in expanding the coverage of social protection mechanisms in health, the Tunisian healthcare system is still largely funded through direct out-of-pocket payments. This paper seeks to assess financial protection in health in the particular policy and epidemiological transition of Tunisia using nationally representative survey data on healthcare expenditure, utilization and morbidity. The extent to which the healthcare system protects people against the financial repercussions of ill-health is assessed using the catastrophic and impoverishing payment approaches. The characteristics associated with the likelihood of vulnerability to catastrophic health expenditure (CHE) are examined using multivariate logistic regression technique. Results revealed that non-negligible proportions of the Tunisian population (ranging from 4. 5 % at the conservative 40 % threshold of discretionary nonfood expenditure to 12 % at the 10 % threshold of total expenditure) incurred CHE. In terms of impoverishment, results showed that health expenditure can be held responsible for about 18 % of the rise in the poverty gap. These results appeared to be relatively higher when compared with those obtained for other countries with similar level of development. Nonetheless, although households belonging to richer quintiles reported more illness episodes and received more treatment than the poor households, the latter households were more likely to incur CHE at any threshold. Amongst the correlates of CHE, health insurance coverage was significantly related to CHE regardless of the threshold used. Some implications and policy recommendations, which might also be useful for other similar countries, are advanced to enhance the financial protection capacity of the Tunisian healthcare system. © 2013 Springer Science+Business Media New York.
Authors & Co-Authors
Abu-Zaineh, M.
France, Paris
Inserm
France, Marseille
Aix Marseille Université
Ben Romdhane, Habiba
Tunisia, Tunis
Faculté de Médecine de Tunis
Ventelou, Bruno
France, Paris
Inserm
France, Paris
Cnrs Centre National de la Recherche Scientifique
Moatti, Jean Paul
France, Paris
Inserm
France, Marseille
Aix Marseille Université
Chokri, Arfa
Tunisia, Tunis
Institut National du Travail et Des Etudes Sociales
Statistics
Citations: 30
Authors: 5
Affiliations: 5
Identifiers
Doi:
10.1007/s10754-013-9123-8
ISSN:
13896563
e-ISSN:
15736962
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Tunisia