Catastrophic health expenditure and impoverishment in Turkey

Health Policy. 2010 Jan;94(1):26-33. doi: 10.1016/j.healthpol.2009.08.006. Epub 2009 Sep 6.


Objectives: This study aims to identify the level of catastrophic health expenditure (CHE) in Turkey and, to reveal household factors predicting this outcome.

Methods: CHE is calculated from a national representative data derived from TurkStat, Household Budget Survey, Consumption Expenditures, 2006. The methods introduced by Ke Xu and colleagues are employed for calculations.

Results: The proportion of households with CHE is 0.6%. Impoverished households consist 0.4% of total. Average out-of-pocket health payment is 7.36 USD (PPP$-2006) in lowest fifth that is approximately one tenth of the highest fifth (70.18 PPP USD-2006). In the logistic model, probability of facing CHE increases by each unit rise of per capita expenditure. Household head's health insurance is closely related with catastrophe. Rural households face 2.5 times more catastrophe than the urban area residents. Having preschool child in the household is seen as a protective factor for catastrophic expenditure. On the other hand, elderly or disabled person increases risk of catastrophe.

Conclusions: Results indicate that more people in Turkey benefited from risk pooling/health insurance by 2006 and were, therefore, on average, better protected from catastrophic medical expenses, than in many other countries with comparable income levels at that time.

MeSH terms

  • Budgets / statistics & numerical data
  • Catastrophic Illness / economics*
  • Chi-Square Distribution
  • Cost Sharing
  • Family Characteristics
  • Female
  • Financing, Personal / economics*
  • Health Care Reform
  • Health Expenditures / statistics & numerical data*
  • Health Services Research
  • Humans
  • Insurance, Health / economics*
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Poverty / economics*
  • Risk Sharing, Financial / economics
  • Rural Health / statistics & numerical data
  • Turkey
  • Urban Health / statistics & numerical data