Background Access to appropriate and affordable healthcare is needed to achieve better health outcomes in Africa. However, access to healthcare remains low, especially among the poor. In Zambia, poor access exists despite the policy by the government to remove user fees in all primary healthcare facilities in the public sector. The paper has two main objectives: (i) to examine the factors assoc...

OBJECTIVES The Medicare Modernization Act of 2003 calls for medication therapy management programs (MTMPs) to control anticipated growth in drug use and expenditures. In 2006, prescription drug plan sponsors, including health plans, pharmacy benefit managers, and other entities, will be required to offer MTMP services performed by pharmacists or other health professionals. The Pharmacist Review...

Janet is a 67-year-old woman with metastatic breast cancer. Despite having insurance, Janet has been saddled with life-altering out-of-pocket expenses from her cancer treatment. In Part I of this two-part series, we described how Janet’s struggle with out-of-pocket expenses was not unique; a growing body of evidence has detailed the negative impact of costs on insured patients receiving cancer ...

BACKGROUND China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. METHODS We used progressivity analysis and dominance test to evaluate the financing channels ...

BACKGROUND As healthcare spending continues to increase, medical insurance is now under great pressure of growing economic burden. To control the excessive growth of medical expenditure, change of medical payment system was clearly put forward in China's new healthcare reform. With this end, Tianjin, a large city in North China, is now exploring to replace traditional fee-for-service (FFS) with...

Introduction Chronic Kidney Disease (CKD) has significant economic impact on both patients’ households and the country. Objectives To assess the out-of-pocket (OOP) expenditure of accessing health services among CKD patients in Anuradhapura District Methods This community based cross-sectional study included a representative sample of 1174 registered CKD patients from all 19 Medical Officer...

Health Insurance (HI) programmes in low-income countries aim to reduce the burden of out-of-pocket (OOP) health care expenditure. However, if the decisions to purchase insurance and to seek care when ill are correlated with the expected health care expenditure, the use of naïve regression models may produce biased estimates of the impact of insurance membership on OOP expenditure. Whilst many s...

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher ...

OBJECTIVE We examined the association between state Medicaid and State Children's Health Insurance Program (SCHIP) income eligibility and the financial burden reported by low-income families raising children with special health care needs (CSHCN). SAMPLE AND METHODS Data on low-income CSHCN and their families were from the National Survey of Children With Special Health Care Needs (N = 17039)...

This article presents data about expenses and sources of payment for nursing homes for 1987 and 1996. A central finding is that the role of Medicare in financing nursing home care has greatly expanded. Medicare payments represent 2 and 19 percent of the total for 1987 and 1996, respectively. As Medicare's role increased, there was an accompanying decline in the proportion of expenses paid out o...