The Impovershing Effect of Ill Health: Evidence from the Western Balkans

Centro Studi Luca d'Agliano Development Studies Working Paper No. 243

39 Pages Posted: 12 Dec 2008

See all articles by Mariapia Mendola

Mariapia Mendola

University of Milan - Centro Studi Luca d'Agliano (LdA); Università degli Studi di Milano-Bicocca - Department of Economics, Management and Statistics (DEMS); Università degli Studi di Milano-Bicocca - Center for European Studies (CefES)

Caryn Bredenkamp

World Bank - Health, Nutrition and Population

Michele Gragnolati

World Bank - Latin America and Caribbean Region

Date Written: April 2008

Abstract

This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia and Kosovo) have succeeded in providing financial protection against adverse health events. We examine disparities in health status, health care utilization and out-of-pocket payments for health care (including informal payments), and explore the impact of health care expenditures on household economic status and poverty. Data are drawn from LSMS surveys and methodologies include 'catastrophic-health' analysis, poverty incidence analysis adjusted for health payments, and multivariate regression analysis. On balance, we find that economic status is significantly associated with health care-seeking behavior in all transition economies and the cost of illness can increase the incidence and depth of poverty. The impoverishing effect of health expenditures is most severe in Albania and Kosovo, followed by Serbia, Bosnia and Herzegovina and Montenegro. Moreover, health care costs seem to place a heavier burden on the weakest strata of the population, such as children and people with chronic illness, with serious consequences for the breaking out of the illness-poverty vicious circle.

Keywords: Health system, Health care expenditure, Poverty, Western Balkans

JEL Classification: H51, I10, I32, P36

Suggested Citation

Mendola, Mariapia and Bredenkamp, Caryn and Gragnolati, Michele, The Impovershing Effect of Ill Health: Evidence from the Western Balkans (April 2008). Centro Studi Luca d'Agliano Development Studies Working Paper No. 243. Available at SSRN: https://ssrn.com/abstract=1314858 or http://dx.doi.org/10.2139/ssrn.1314858

Mariapia Mendola (Contact Author)

University of Milan - Centro Studi Luca d'Agliano (LdA) ( email )

Via Conservatorio 7
Milano, 20122
Italy

Università degli Studi di Milano-Bicocca - Department of Economics, Management and Statistics (DEMS) ( email )

Piazza dell'Ateneo Nuovo, 1
Milan, 20126
Italy

Università degli Studi di Milano-Bicocca - Center for European Studies (CefES)

U6 Building
Viale Piero e Alberto Pirelli, 22
Milano, 20126
Italy

Caryn Bredenkamp

World Bank - Health, Nutrition and Population ( email )

United States

Michele Gragnolati

World Bank - Latin America and Caribbean Region ( email )

1818 H Street NW
Washington, DC 20433
United States

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