Household Dynamics in the Financing of Health Care and Its Implication on Universal Health Coverage: A Systematic Review

There is strong evidence that out-of-pocket expenditure, negatively affects healthcare utilization, leading to adverse health consequences. This systematic review explores the financial burden of treatment and medication for households, and the extent to which this burden caused them to forgo or discontinue treatment. We included 20 studies conducted in America, Africa, Asia and the Pacific. All relevant studies reviewed conclude that out of pocket expenditure decreases the utilization of healthcare services because they make them more costly. The reviewed studies rely on both existing data and primary data collected through surveys. Thirteen studies reported a cost-related reduction in medication adherence and loss to follow up. Four studies reported a cost-related reduction in healthcare services demand while two studies reported the impact of out-of-pocket payments on the choice of healthcare provider. One study reported on the impact of out-of-pocket payments on the choice of healthcare services. Financing strategies should be put in place to further reduce household out-of-pocket costs, reduce or subsidize time and transportation costs for households seeking public and private care; and increase transparency of costs and quality to improve household decisions. Drug plan managers should also consider the effects that medication cost-sharing levels may have on health outcomes in children with asthma, particularly with regard to the use of controller medications.
http://article.sapub.org/10.5923.j.phr.20201005.02.html