Determinants of Catastrophic Health Expenditures: The Case of Turkey

Yıl 2023, Cilt: 7 Sayı: 2, 629 - 648, 31.05.2023

Banu Beyaz Sipahi

https://doi.org/10.29023/alanyaakademik.1032738

Öz

Equal access to healthcare services and their usage is important because the utilization of healthcare services can create an unforeseeable financial burden on individuals and households. It has been stated that if households have to finance their healthcare services by reducing their basic expenses or if out-of-pocket expenditures exceed or encompass a significant portion of household expenditures during a certain period, catastrophic health spending occurs. Study uses the data of Household Budget Expenditure Survey by Turkstat with 2018 year. The determinants of catastrophic health expenditures were determined with the logit model and the impoverishing effect of these expenditures was evaluated together. According to the results, the proportion of households spending on catastrophic health was calculated as 1.43% and the proportion of households being driven to poverty as a result of catastrophic health expenditures was calculated as 0.26 %. In addition, the presence of an individual aged 65 and over in the household and the lowest income group increase the likelihood of catastrophic health spending. It has been concluded that these expenditures deepen poverty together with the high rate of catastrophic health expenditures in low-income groups in Turkey.

Anahtar Kelimeler

Catastrophic Health Expenditures, Poverty, Out-of-Pocket Health Expenditures, Socio-Economic Factors

Katastrofik Sağlık Harcamalarının Belirleyicileri: Türkiye Örneği

Öz

Sağlık hizmetlerine ulaşımının ve kullanımının eşit bir şekilde sağlanması önem arz etmektedir. Çünkü sağlık hizmetleri kullanımı bireyler ve hanehalkları üzerinde öngörülemeyecek finansal yük yaratabilmektedir. Belirli bir dönemde hanelerin sağlık hizmetlerini finanse edebilmek için temel harcamalarını kısması ya da cepten yapılan harcamalarının hanehalkının harcamasını aşması veya büyük bir bölümünü kapsaması durumunda katastrofik sağlık harcaması ortaya çıktığı ifade edilmiştir. Türkiye İstatistik Kurumunun (TÜİK) 2018 Hanehalkı Bütçe Anketi (HBA) verileri kullanılarak, katastrofik sağlık harcamalarının belirleyicileri lojistik regresyon modeli ile incelenmiş ve bu harcamaların yoksullaştırıcı etkisi birlikte değerlendirilmiştir. Sonuçlara göre, katastrofik sağlık harcaması yapan hane oranı %1.43 ve katastrofik sağlık harcamaları sonucunda yoksulluğa sürüklenen hane oranı ise %0.26 olarak hesaplanmıştır. Hanede 65 yaş ve üstü bireyin olması ve en düşük gelir grubun katastrofik sağlık harcama yapma olasılığını artırmaktadır. Oysa hanehalkı büyüklüğünün artması, hanede beş yaş ve altı bireyin olması, hanehalkı reisinin evli olması ve hanede lise ve üstü eğitim düzeyine sahip bireyin olması katastrofik sağlık harcama yapma olasılığını azaltmaktadır. Türkiye’de düşük gelir gruplarında katastrofik sağlık harcama oranı yüksek olması ile birlikte bu harcamaların yoksulluğu derinleştirdiği sonucuna ulaşılmıştır.

Anahtar Kelimeler

Katastrofik Sağlık Harcaması, Yoksulluk, Cepten Yapılan Sağlık Harcaması, Sosyoekonomik Faktörler

Kaynakça

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