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Equity in public health spending in Ethiopia: a benefit incidence analysis
Inequality in access and utilization of health services because of socioeconomic status is unfair, and it should be monitored and corrected with appropriate remedial action. Therefore, this study aimed to estimate the distribution of benefits from public spending on health care across socioeconomic...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633598/ https://www.ncbi.nlm.nih.gov/pubmed/34849900 http://dx.doi.org/10.1093/heapol/czab060 |
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author | Hailu, Alemayehu Gebreyes, Roman Norheim, Ole F |
author_facet | Hailu, Alemayehu Gebreyes, Roman Norheim, Ole F |
author_sort | Hailu, Alemayehu |
collection | PubMed |
description | Inequality in access and utilization of health services because of socioeconomic status is unfair, and it should be monitored and corrected with appropriate remedial action. Therefore, this study aimed to estimate the distribution of benefits from public spending on health care across socioeconomic groups in Ethiopia using a benefit incidence analysis. We employed health service utilization data from the Living Standard Measurement Survey, recurrent government expenditure data from the Ministry of Finance and health services delivery data from the Ministry of Health’s Health Management Information System. We calculated unit subsidy as the ratio of recurrent government health expenditure on a particular service type to the corresponding number of health services visits. The concentration index (CI) was applied to measure inequality in health care utilization and the distribution of the subsidy across socioeconomic groups. We conducted a disaggregated analysis comparing health delivery levels and service types. Furthermore, we used decomposition analysis to measure the percentage contribution of various factors to the overall inequalities. We found that 61% of recurrent government spending on health goes to health centres (HCs), and 74% was spent on outpatient services. Besides, we found a slightly pro-poor public spending on health, with a CI of −0.039, yet the picture was more nuanced when disaggregated by health delivery levels and service types. The subsidy at the hospital level and for inpatient services benefited the wealthier quintiles most. However, at the HC level and for outpatient services, the subsidies were slightly pro-poor. Therefore, an effort is needed in making inpatient and hospital services more equitable by improving the health service utilization of those in the lower quintiles and those in rural areas. Besides, policymakers in Ethiopia should use this evidence to monitor inequity in government spending on health, thereby improving government resources allocation to target the disadvantaged better. |
format | Online Article Text |
id | pubmed-8633598 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-86335982021-12-01 Equity in public health spending in Ethiopia: a benefit incidence analysis Hailu, Alemayehu Gebreyes, Roman Norheim, Ole F Health Policy Plan Supplement Article Inequality in access and utilization of health services because of socioeconomic status is unfair, and it should be monitored and corrected with appropriate remedial action. Therefore, this study aimed to estimate the distribution of benefits from public spending on health care across socioeconomic groups in Ethiopia using a benefit incidence analysis. We employed health service utilization data from the Living Standard Measurement Survey, recurrent government expenditure data from the Ministry of Finance and health services delivery data from the Ministry of Health’s Health Management Information System. We calculated unit subsidy as the ratio of recurrent government health expenditure on a particular service type to the corresponding number of health services visits. The concentration index (CI) was applied to measure inequality in health care utilization and the distribution of the subsidy across socioeconomic groups. We conducted a disaggregated analysis comparing health delivery levels and service types. Furthermore, we used decomposition analysis to measure the percentage contribution of various factors to the overall inequalities. We found that 61% of recurrent government spending on health goes to health centres (HCs), and 74% was spent on outpatient services. Besides, we found a slightly pro-poor public spending on health, with a CI of −0.039, yet the picture was more nuanced when disaggregated by health delivery levels and service types. The subsidy at the hospital level and for inpatient services benefited the wealthier quintiles most. However, at the HC level and for outpatient services, the subsidies were slightly pro-poor. Therefore, an effort is needed in making inpatient and hospital services more equitable by improving the health service utilization of those in the lower quintiles and those in rural areas. Besides, policymakers in Ethiopia should use this evidence to monitor inequity in government spending on health, thereby improving government resources allocation to target the disadvantaged better. Oxford University Press 2021-11-12 /pmc/articles/PMC8633598/ /pubmed/34849900 http://dx.doi.org/10.1093/heapol/czab060 Text en © The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Supplement Article Hailu, Alemayehu Gebreyes, Roman Norheim, Ole F Equity in public health spending in Ethiopia: a benefit incidence analysis |
title | Equity in public health spending in Ethiopia: a benefit incidence analysis |
title_full | Equity in public health spending in Ethiopia: a benefit incidence analysis |
title_fullStr | Equity in public health spending in Ethiopia: a benefit incidence analysis |
title_full_unstemmed | Equity in public health spending in Ethiopia: a benefit incidence analysis |
title_short | Equity in public health spending in Ethiopia: a benefit incidence analysis |
title_sort | equity in public health spending in ethiopia: a benefit incidence analysis |
topic | Supplement Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633598/ https://www.ncbi.nlm.nih.gov/pubmed/34849900 http://dx.doi.org/10.1093/heapol/czab060 |
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