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Who benefits from healthcare spending in Cambodia? Evidence for a universal health coverage policy
- Source :
- Health Policy and Planning
- Publication Year :
- 2019
- Publisher :
- Oxford University Press, 2019.
-
Abstract
- © 2019 The Author(s) 2019. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. Cambodia's healthcare system has seen significant improvements in the last two decades. Despite this, access to quality care remains problematic, particularly for poor rural Cambodians. The government has committed to universal health coverage (UHC) and is reforming the health financing system to align with this goal. The extent to which the reforms have impacted the poor is not always clear. Using a system-wide approach, this study assesses how benefits from healthcare spending are distributed across socioeconomic groups in Cambodia. Benefit incidence analysis was employed to assess the distribution of benefits from health spending. Primary data on the use of health services and the costs associated with it were collected through a nationally representative cross-sectional survey of 5000 households. Secondary data from the 2012-14 Cambodia National Health Accounts and other official documents were used to estimate the unit costs of services. The results indicate that benefits from health spending at the primary care level in the public sector are distributed in favour of the poor, with about 32% of health centre benefits going to the poorest population quintile. Public hospital outpatient benefits are quite evenly distributed across all wealth quintiles, although the concentration index of -0.058 suggests a moderately pro-poor distribution. Benefits for public hospital inpatient care are substantially pro-poor. The private sector was significantly skewed towards the richest quintile. Relative to health need, the distribution of total benefits in the public sector is pro-poor while the private sector is relatively pro-rich. Looking across the entire health system, health financing in Cambodia appears to benefit the poor more than the rich but a significant proportion of spending remains in the private sector which is largely pro-rich. There is the need for some government regulation of the private sector if Cambodia is to achieve its UHC goals.
- Subjects :
- Male
Financing, Government
health financing
Population
Supplement Articles
universal health coverage
Health Services Accessibility
Universal Health Insurance
Development economics
Health care
Benefit incidence
Humans
benefit incidence analysis
Healthcare Disparities
education
Developing Countries
Poverty
education.field_of_study
Public Sector
Equity (economics)
Inpatient care
business.industry
Health Policy
Public sector
Equity
Health Services
Private sector
Cross-Sectional Studies
Public hospital
Health Policy & Services
Female
Private Sector
Business
Cambodia
Subjects
Details
- Language :
- English
- ISSN :
- 14602237 and 02681080
- Volume :
- 34
- Issue :
- Suppl 1
- Database :
- OpenAIRE
- Journal :
- Health Policy and Planning
- Accession number :
- edsair.doi.dedup.....1fa65821c5681c5511c6d410fede1d50