Déterminants de l'accès aux soins et des dépenses de santé en Tunisie

Ismaïl, Safa (2021): Déterminants de l'accès aux soins et des dépenses de santé en Tunisie.

Abstract

This study aims to estimate and analyze the impact of the determinants of health care access and consumption in Tunisia. The estimation is made using two models: the “Heckman selection model” and the “Two-part model”, using a representative sample of 25091 households from the National households’ survey of budget, consumption and living standards in 2015. Similar results were obtained for both models. Access to health care and Out-of-pocket health expenditure increase with the household’s standard of living. They increase also for individuals with chronic disease and for those with disabilities, for households with children under five years and in rural areas. Out-of-pocket health expenditure increases for elderly and decreases with health insurance coverage.

• Item Type: MPRA Paper
• English Title: Determinants of health care consumption in Tunisia
• Language: French
• Keywords: Out-of-pocket health expenditure; Health care access; Tunisia
• Subjects: I - Health, Education, and Welfare > I1 - Health

References

Abu-Zaineh, M., H. B. Romdhane, B. Ventelou, J.-P. Moatti and A. Chokri (2013). "Appraising financial protection in health: the case of Tunisia." International journal of health care finance and economics 13(1): 73-93.

Belotti, F., P. Deb, W. Manning and E. Norton (2012). "Tpm: estimating two-part models." Stata J 5(2): 1-13. CNS (2012-2013). Comptes nationaux de la santé 2012-2013, Ministère de la santé.

CRES (2019). Études de faisabilité des garanties du Socle National de Protection Sociale., Centre de Recherches et d’Etudes Sociales (CRES), Ministère des affaires sociales.

Galárraga, O., S. G. Sosa-Rubí, A. Salinas-Rodríguez and S. Sesma-Vázquez (2010). "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico." The European Journal of Health Economics 11(5): 437-447.

Heckman, J. J. (1979). "Sample selection bias as a specification error." Econometrica: Journal of the econometric society: 153-161.

INS (2015). Enquête nationale sur le budget, la consommation et le niveau de vie des ménages 2015. Institut National de la Statistique. Tunisie.

Leive, A. and K. Xu (2008). "Coping with out-of-pocket health payments: empirical evidence from 15 African countries." Bulletin of the World Health Organization 86: 849-856C.

Li, Y., Q. Wu, L. Xu, D. Legge, Y. Hao, L. Gao, N. Ning and G. Wan (2012). "Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of universal health insurance." Bulletin of the World Health Organization 90: 664-671.

Manning, W. G. and J. Mullahy (2001). "Estimating log models: to transform or not to transform?" Journal of health economics 20(4): 461-494.

Murray, C. and D. Evans (2003). "Household health system contributions and capacity to pay: definitional, empirical, and technical challenges." Health System Performance Assessment.

RAYNAUD, D. (2002). "Les déterminants individuels des dépenses de santé: Les dépenses de santé." Dossiers solidarité et santé(1): 29-58.

Somkotra, T. and L. P. Lagrada (2009). "Which Households Are At Risk Of Catastrophic Health Spending: Experience In Thailand After Universal Coverage: Exploring the reasons why some households still incur high levels of spending—even under universal coverage—can help policymakers devise solutions." Health affairs 28(Suppl1): w467-w478.

Van Minh, H., N. T. K. Phuong, P. Saksena, C. D. James and K. Xu (2013). "Financial burden of household out-of pocket health expenditure in Viet Nam: findings from the National Living Standard Survey 2002–2010." Social science & medicine 96: 258-263.

Wagstaff, A. and S. S. Lieberman (2009). Health Financing and Delivery in Vietnam: Looking Forward, The World Bank.

World Health Organization (2017). Together on the road to universal health coverage: a call to action. Geneva.

World Health Organization (2020). "Global monitoring report on financial protection in health 2019."