title: Protecting households from catastrophic health spending.
abstract: Many countries rely heavily on patients' out-of-pocket payments to providers to finance their health care systems. This prevents some people from seeking care and results in financial catastrophe and impoverishment for others who do obtain care. Surveys in eighty-nine countries covering 89 percent of the world's population suggest that 150 million people globally suffer financial catastrophe annually because they pay for health services. Prepayment mechanisms protect people from financial catastrophe, but there is no strong evidence that social health insurance systems offer better or worse protection than tax-based systems do.
authors.affiliation: Department of Health Systems Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.forename: David B
authors.initials: DB
authors.lastname: Evans
authors.forename: Guido
authors.initials: G
authors.lastname: Carrin
authors.forename: Ana Mylena
authors.initials: AM
authors.lastname: Aguilar-Rivera
authors.forename: Philip
authors.initials: P
authors.lastname: Musgrove
authors.forename: Timothy
authors.initials: T
authors.lastname: Evans
mesh_terms: D002388:Catastrophic Illness / Q000191:economics*; D017281:Cost of Illness; D003431:Cross-Cultural Comparison; D003695:Delivery of Health Care / Q000191:economics*; D019049:Developed Countries / Q000191:economics; D003906:Developing Countries / Q000191:economics; D005191:Family Characteristics; D005380:Financing, Government / Q000706:statistics & numerical data; D005382:Financing, Personal / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000592:standards* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D009313:National Health Programs / Q000191:economics*; D011203:Poverty / Q000706:statistics & numerical data; D012044:Regression Analysis