Economic Consequences on Households of Illnesses Requiring Hospital Referrals: Evidence from Atsamat Hospital to Roi Et Hospital

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Patchareeya Suwannasri
Supon Limwattananon
Areewan Cheawchanwattana


This study aimed to assess impacts on food and non-food consumption pattern and to study coping
strategies for catastrophic expenditure in households whose ill members were referred from Atsamat Hospital to Roi Et Hospital between 1st April to 31st August 2009 under the universal health care coverage (UC) scheme. Two hundred and fifty working-age household members were approached at four months after the referral using structured and in-depth interviews, and direct observation. Twenty two percent of the households had to reduce their regular consumption. The out-of-pocket (OOP) payments accounted for 31.9% of total monthly expenditures, of which, health care and non-health shared 7.4% and 24.5%, respectively. Most of the OOP payments were for food (48.9%) and transportation (37.5%). The affected households were poorer, had longer length of hospital stay and had more chronic diseases than the non-affected ones (p<0.05). Moreover, financial burdens in the affected households were higher than on the non-affected ones despite statistical non-significance (p>0.05). Households used varieties of strategies to cope with the economic consequences of the hospital-referred illness. While the most common method was to use available cash, savings and remittance from relatives, other included borrowing from families and friends and sale of assets. Thus, development of appropriate social and health insurance policies could help mitigate household impoverishment due to illness.


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