000			03581cam a22005894a 4500
001			5234
003			The World Bank
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007			cr cn|||||||||
008			020129s2010 dcu i001 0 eng
024	8		_a10.1596/1813-9450-5234
035			_a(The World Bank)5234
100	1		_aWagstaff, Adam
245	1	0	_aBenefit Incidence Analysis _h[electronic resource] : _bAre Government Health Expenditures More Pro-Rich Than We Think ? / _cWagstaff, Adam
260			_aWashington, D.C., _bThe World Bank, _c2010
300			_a1 online resource (25 p.)
520	3		_aIt is generally accepted that government health expenditures should disproportionately benefit the poor. And yet in most developing countries the opposite is the case. This paper examines the implications of a central assumption of benefit incidence analysis, namely that the unit cost of a government-provided service bears no relation to the out-of-pocket payments paid by the patient. It argues that a more plausible assumption is that larger out-of-pocket payments for a given unit of utilization reflect more (or more costly) services being delivered. The paper compares - theoretically and empirically - the standard constant-cost assumption with two alternatives, namely that the cost of care in a specific episode of utilization is (a) proportional to or (b) linearly related to the amount of money paid out-of-pocket by the patient. An interesting special case of the linear relationship is where subsidies are focused on a basic unit of care and additional costs are met dollar-for-dollar by additional fees. The paper shows that if fees are more pro-rich than utilization, government spending will be least pro-rich under the constant-cost assumption and most pro-rich under the proportionality assumption. The linear assumption results in a concentration index for subsidies that lies between these two extremes. These results are borne out in an analysis of the incidence of government health spending in Vietnam (a country where fees are more pro-rich than utilization); indeed, under the constant-cost assumption, subsidies are pro-poor while they are pro-rich under the proportionality assumption. The paper also considers the biases created by not allowing for insurance reimbursements.
650		4	_aClinics
650		4	_aEconomic Theory & Research
650		4	_aHealth
650		4	_aHealth expenditures
650		4	_aHealth Monitoring & Evaluation
650		4	_aHealth services
650		4	_aHealth systems
650		4	_aHealth Systems Development & Reform
650		4	_aHospitals
650		4	_aHuman development
650		4	_aIncidence analysis
650		4	_aIncome
650		4	_aInpatient care
650		4	_aInsurance
650		4	_aMacroeconomics and Economic Growth
650		4	_aMedicines
650		4	_aNutrition and Population
650		4	_aOutpatient care
650		4	_aPatient
650		4	_aPatients
650		4	_aPrimary health care
650		4	_aPublic health
650		4	_aPublic Sector Development
650		4	_aPublic Sector Management and Reform
650		4	_aSchool health
650		4	_aSchool health care
650		4	_aSocial services
650		4	_aUrban Development
650		4	_aUrban Economics
650		4	_aWorkers
700	1		_aWagstaff, Adam
776	1	8	_aPrint version: _iWagstaff, Adam. _tBenefit Incidence Analysis. _dWashington, D.C., The World Bank, 2010
830		0	_aPolicy research working papers.
830		0	_aWorld Bank e-Library.
856	4	0	_uhttp://elibrary.worldbank.org/doi/book/10.1596/1813-9450-5234
999			_c140993 _d140993