Official websites use. Share sensitive information only on official, secure websites. To quantify extent of catastrophic household health expenditures, determine factors influencing it and estimate Fairness in Financial Contribution FFC index in Georgia to establish the baseline for expected reforms and contribute to the design and fine-tuning of the major reforms in health care financing initiated by the government mid The research is based on the nationally representative Health Care Utilization and Expenditure survey conducted during May-June , prior to preparing for new phase of implementation for the health care financing reforms.
Households' catastrophic health expenditures were estimated according to the methodology proposed by WHO — Ke Xu [ 1 ]. A logistic regression logit model was used to predict probability of catastrophic health expenditure occurrence. In Georgia between and access to care for poor has improved slightly and the share of households facing catastrophic health expenditures have seemingly increased from 2. However, this variance may be associated with the methodological differences of the respective surveys from which the analysis were derived.
The high level of the catastrophic health expenditure may be associated with the low share of prepayment in national health expenditure, adequate availability of services and a high level of poverty in the country. Major factors determining the financial catastrophe related to ill health were hospitalization, household members with chronic illness and poverty status of the household. The FFC for Georgia appears to have improved since Reducing the prevalence of catastrophic health expenditure is a policy objective of the government, which can be achieved by focusing on increased financial protection offered to poor and expanding government financed benefits for poor and chronically ill by including and expanding inpatient coverage and adding drug benefits.
This policy recommendation may also be relevant for other Low and Middle Income countries with similar levels of out of pocket payments and catastrophic health expenditures. After gaining independence from Soviet Union in , Georgia faced the deepest economic shock among all former Soviet republics. In response to the declining public spending during —, the government of Georgia, as other countries of former socialist block in Europe and Central Asia, has embarked on major health sector reforms, which separated health care provision from financing, helped the country establish a single purchaser in that contracted providers and introduced output-based payments as the predominant form of provider reimbursement.
Structural reforms allowed the government to remove up to , health care workers from the state payroll and devolved hiring and firing powers onto autonomous but publicly owned health care facilities, which emerged as a result of these reforms. In light of limited public spending on health and a very narrow benefit package, private out-of-pocket payments emerged as a predominant source of financing service provision.
