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Open AccessArticle

Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain

1
Castilla-La Mancha Health Services, SESCAM, Hospital of Cuenca, C/Hermandad de Donantes de Sangre, 1, 16002 Cuenca, Spain
2
Department of Economic Analysis and Finance, University of Castilla-La Mancha, Avda. Los Alfares, 44, 16071 Cuenca, Spain
3
Research Group on Food, Economy and Society, University of Castilla-La Mancha, Avda. Los Alfares, 44, 16071 Cuenca, Spain
4
Department of Applied and Public Economics, and Political Economy, Complutense University of Madrid, Campus de Somosaguas s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
5
Department of Economic Analysis and Finance, University of Castilla-La Mancha, Plaza de la Universidad s/n, 02001 Albacete, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(3), 932; https://doi.org/10.3390/ijerph18030932
Received: 12 January 2021 / Accepted: 19 January 2021 / Published: 21 January 2021
(This article belongs to the Special Issue The Economics of Caring)
Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households’ out-of-pocket payments associated with health care during the period 2008–2015. Methods. The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated. Results. The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP). Conclusion. The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs. View Full-Text
Keywords: Spain; out-of-pocket payments; health; catastrophic; health insurance; households; economic crisis Spain; out-of-pocket payments; health; catastrophic; health insurance; households; economic crisis
MDPI and ACS Style

López-López, S.; del Pozo-Rubio, R.; Ortega-Ortega, M.; Escribano-Sotos, F. Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain. Int. J. Environ. Res. Public Health 2021, 18, 932. https://doi.org/10.3390/ijerph18030932

AMA Style

López-López S, del Pozo-Rubio R, Ortega-Ortega M, Escribano-Sotos F. Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain. International Journal of Environmental Research and Public Health. 2021; 18(3):932. https://doi.org/10.3390/ijerph18030932

Chicago/Turabian Style

López-López, Samuel; del Pozo-Rubio, Raúl; Ortega-Ortega, Marta; Escribano-Sotos, Francisco. 2021. "Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain" Int. J. Environ. Res. Public Health 18, no. 3: 932. https://doi.org/10.3390/ijerph18030932

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