title: Catastrophic health expenditure and impoverishment in Mongolia.
abstract: The social health insurance coverage is relatively high in Mongolia; however, escalation of out-of-pocket payments for health care, which reached 41 % of the total health expenditure in 2011, is a policy concern. The aim of this study is to analyse the incidence of catastrophic health expenditures and to measure the rate of impoverishment from health care payments under the social health insurance scheme in Mongolia.
  
  
  
  We used the data from the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. Catastrophic health expenditures are defined an excess of out-of-pocket payments for health care at the various thresholds for household total expenditure (capacity to pay). For an estimate of the impoverishment effect, the national and The Wold Bank poverty lines are used.
  
  
  
  About 5.5 % of total households suffered from catastrophic health expenditures, when the threshold is 10 % of the total household expenditure. At the threshold of 40 % of capacity to pay, 1.1 % of the total household incurred catastrophic health expenditures. About 20,000 people were forced into poverty due to paying for health care.
  
  
  
  Despite the high coverage of social health insurance, a significant proportion of the population incurred catastrophic health expenditures and was forced into poverty due to out-of-pocket payments for health care.
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia. javkhlanbayar.d@gmail.com.|Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland. javkhlanbayar.d@gmail.com.
authors.forename: Javkhlanbayar
authors.initials: J
authors.lastname: Dorjdagva
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia.
authors.forename: Enkhjargal
authors.initials: E
authors.lastname: Batbaatar
authors.affiliation: Health Metrics Unit, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Svensson
authors.affiliation: Department of Health Systems Governance and Financing, WHO, Geneva, Switzerland.
authors.forename: Bayarsaikhan
authors.initials: B
authors.lastname: Dorjsuren
authors.affiliation: Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Kauhanen
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D005191:Family Characteristics; D005260:Female; D005382:Financing, Personal; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008986:Mongolia; D011203:Poverty; D011795:Surveys and Questionnaires
keywords: Catastrophic health expenditure; Financial protection; Impoverishment; Mongolia