The United Nations Sustainable Development Goals (SDGs) have highlighted the importance of equitable utilization of healthcare services for those in need and protecting them against financial risks associated with healthcare expenditure for both developed and developing countries. Worldwide, more than 150 million people face financial catastrophe and approximately, 100 million are dragged into poverty annually due to out-of-pocket healthcare expenditure. Hence, equality in healthcare utilization and out-of-pocket healthcare expenditure among people plays a vital role in ensuring healthy lives and promotion of well-being for all. The governments in developed and developing countries alike are under intense political pressures as they are expected to implement healthcare policy makers’ recommendations by increasing budgetary allocations for the subject to ensure equal access to different types of healthcare services without suffering from financial hardships. The empirical evidence available to date demonstrate that socio-economic inequalities both in healthcare utilization and out-of-pocket health expenses have widened in spite of increased-budgetary allocations made by the governments. This trend has resulted in deteriorated-health outcomes and increased-morbidity and mortality among disadvantaged-groups in countries. Moreover, uneven geographical distribution of healthcare infrastructure particularly in low-and-middle-income countries creates a barrier to those living in remote areas with poor resource bases.
Investigating the degree to which inequalities persist in healthcare utilization and out-of-pocket healthcare expenditure and examining the factors affecting such inequalities are vital to the health systems to boost their performance. Findings would also be beneficial for policy makers to evaluate the progress of the policy measures taken to reduce inequalities. To this end, the empirical studies for this Research Topic can primarily be directed towards the horizontal equality approach, a traditional but a policy-oriented approach, measuring unequal utilization of healthcare services and out-of-pocket expenditure by socio-economic status for equal healthcare needs. In terms of research methods, the studies may apply regression analyses, concentration index, and decomposition methods to examine, quantify, and explain inequalities. Due to several methodological challenges associated with those methods, recently, the application of longitudinal methods and use of administrative data to deal with inequalities in healthcare utilization and out-of-pocket healthcare expenditure are highly promoted.
With this conceptual note, we invite empirical and theoretical research papers on various aspects of inequality in healthcare utilization and out-of-pocket healthcare expenditure in developing countries where policy options available to address inequalities are limited. The research papers on inequality aspects of different healthcare services including out-patient care, in-patient care, dental services, maternity clinics, and health screening would provide useful policy insights. Also, inequality aspects of out-of-pocket health expenses can be examined by different micro level components of total health expenditure. For instance, expenses for medicines, laboratory tests, doctor fees, consultation fees, and associated other expenses can be examined from equality point of view. Moreover, useful policy insights may be derived from the studies analyzing such inequalities by different sub-populations. Thus, we also encourage the studies on the aspects of inequality in healthcare utilization and out-of-pocket healthcare expenses among vulnerable sub-populations like people with NCDs and acute illnesses, pregnant mothers, elderly people, and so forth.
The United Nations Sustainable Development Goals (SDGs) have highlighted the importance of equitable utilization of healthcare services for those in need and protecting them against financial risks associated with healthcare expenditure for both developed and developing countries. Worldwide, more than 150 million people face financial catastrophe and approximately, 100 million are dragged into poverty annually due to out-of-pocket healthcare expenditure. Hence, equality in healthcare utilization and out-of-pocket healthcare expenditure among people plays a vital role in ensuring healthy lives and promotion of well-being for all. The governments in developed and developing countries alike are under intense political pressures as they are expected to implement healthcare policy makers’ recommendations by increasing budgetary allocations for the subject to ensure equal access to different types of healthcare services without suffering from financial hardships. The empirical evidence available to date demonstrate that socio-economic inequalities both in healthcare utilization and out-of-pocket health expenses have widened in spite of increased-budgetary allocations made by the governments. This trend has resulted in deteriorated-health outcomes and increased-morbidity and mortality among disadvantaged-groups in countries. Moreover, uneven geographical distribution of healthcare infrastructure particularly in low-and-middle-income countries creates a barrier to those living in remote areas with poor resource bases.
Investigating the degree to which inequalities persist in healthcare utilization and out-of-pocket healthcare expenditure and examining the factors affecting such inequalities are vital to the health systems to boost their performance. Findings would also be beneficial for policy makers to evaluate the progress of the policy measures taken to reduce inequalities. To this end, the empirical studies for this Research Topic can primarily be directed towards the horizontal equality approach, a traditional but a policy-oriented approach, measuring unequal utilization of healthcare services and out-of-pocket expenditure by socio-economic status for equal healthcare needs. In terms of research methods, the studies may apply regression analyses, concentration index, and decomposition methods to examine, quantify, and explain inequalities. Due to several methodological challenges associated with those methods, recently, the application of longitudinal methods and use of administrative data to deal with inequalities in healthcare utilization and out-of-pocket healthcare expenditure are highly promoted.
With this conceptual note, we invite empirical and theoretical research papers on various aspects of inequality in healthcare utilization and out-of-pocket healthcare expenditure in developing countries where policy options available to address inequalities are limited. The research papers on inequality aspects of different healthcare services including out-patient care, in-patient care, dental services, maternity clinics, and health screening would provide useful policy insights. Also, inequality aspects of out-of-pocket health expenses can be examined by different micro level components of total health expenditure. For instance, expenses for medicines, laboratory tests, doctor fees, consultation fees, and associated other expenses can be examined from equality point of view. Moreover, useful policy insights may be derived from the studies analyzing such inequalities by different sub-populations. Thus, we also encourage the studies on the aspects of inequality in healthcare utilization and out-of-pocket healthcare expenses among vulnerable sub-populations like people with NCDs and acute illnesses, pregnant mothers, elderly people, and so forth.
