The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan
The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan
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DOI：
10.1093/inthealth/ihz075
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发表时间：
2020-01-01
影响因子：
2.5
通讯作者：
Fatehin, Sohani
中科院分区：
文献类型：
--
作者：
Datta, Biplab K.;Husain, Muhammad J.;Fatehin, Sohani
背景资料：血压升高（即高血压）和糖尿病（BPD）是两种主要的非传染性疾病，使低收入和中等收入国家的家庭面临高昂的自付治疗费用。药物是BPD治疗费用的最大份额，患有BPD的家庭可能需要调整其他商品的消费以支付基本的BPD药物。我们评估如何BPD药物支出与挤出其他家庭日用品在Pakistan.Methods：我们分析了自我报告的家庭消费数据，从全国代表性的巴基斯坦家庭收入和支出调查2015-16。我们估计条件恩格尔曲线下的二次几乎理想的需求系统的框架下，检查BPD药物消费和非消费house.Results之间的平均消费份额的差异：我们发现，BPD药物支出与挤出的食物和其他医疗支出的所有家庭的挤出，但挤出和挤入的幅度较大的贫困家庭。BPD药物支出也与挤出教育和个人护理的中产阶级和富裕的housing.Conclusions：我们的研究结果表明，分配的基本商品，如食品和教育，是较低的BPD药物消费的家庭，并告知政策的预防性健康促进和负担得起的治疗高血压和糖尿病。
Background: Elevated blood pressure (i.e. hypertension) and diabetes (BPD) are the two major noncommunicable diseases that expose households to high out-of-pocket treatment costs in low- and middle-income countries. Medication is the biggest share of BPD treatment expenses, and households with someone suffering from BPD may need to adjust consumption of other commodities to pay for essential BPD medicines. We assess how BPD medication expenditures are associated with crowding out of other household commodities in Pakistan.Methods: We analyze self-reported household consumption data from the nationally representative Pakistan Household Income and Expenditure Survey 2015-16. We estimate conditional Engel curves under the Quadratic Almost Ideal Demand System framework to examine the differences in average consumption shares between BPD medication-consuming and not-consuming households.Results: We find that BPD medication expenditures are associated with crowding out of food and crowding in of other medical expenditures for all households, but the magnitudes of crowding out and crowding in are larger for the poorer households. BPD medication spending is also associated with crowding out of education and personal care for middle-class and wealthier households.Conclusions: Our results indicate that allocations for essential commodities, like food and education, are lower for BPD medication-consuming households and inform policies for preventive health promotions and affordable treatment for hypertension and diabetes.