Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Hailu, Alemayehu, Gebreyes, Roman, Norheim, Ole F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
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
_version_ 1784607963775762432
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
work_keys_str_mv AT hailualemayehu equityinpublichealthspendinginethiopiaabenefitincidenceanalysis
AT gebreyesroman equityinpublichealthspendinginethiopiaabenefitincidenceanalysis
AT norheimolef equityinpublichealthspendinginethiopiaabenefitincidenceanalysis