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Out-of-pocket Health Expenditure in Nepal

Moroni, Matthew LU (2019) UTVK03 20191
Sociology
Abstract
Medical care in Nepal is largely financed by the individual, and although insurance programs and subsidies exist, they are limited in coverage, amount of assistance provided, and level of enrollment. Medical needs that extend beyond basic health services, specifically following acute injury can lead to financial difficulties that may jeopardize the ability to maintain basic needs and can push people into cycles of poverty. Costs for transportation, food, and itemized hospital charges can quickly deplete financial resources and require additional strategies to finance care, often through sale of land, loans, and forgoing of children’s educations. The aim of this study is to both understand strategies that are devised and utilized to finance... (More)
Medical care in Nepal is largely financed by the individual, and although insurance programs and subsidies exist, they are limited in coverage, amount of assistance provided, and level of enrollment. Medical needs that extend beyond basic health services, specifically following acute injury can lead to financial difficulties that may jeopardize the ability to maintain basic needs and can push people into cycles of poverty. Costs for transportation, food, and itemized hospital charges can quickly deplete financial resources and require additional strategies to finance care, often through sale of land, loans, and forgoing of children’s educations. The aim of this study is to both understand strategies that are devised and utilized to finance healthcare following acute medical need and the implications of such strategies. To do so, a qualitative study was conducted in urban and rural Nepal among 10 individuals who experienced acute medical need and consequential high rate of healthcare-related spending. The theoretical framework that guided the study was based on theories of trust, including how trust is generated and exchanged, as well as theory on the male breadwinner, in order to conceptualize the role of men in Nepali society. Finally, theories on social capital, including its significance in enabling relationships between individuals within families and exchanges with members of patients’ local communities were utilized. Results indicate that patients often travel to multiple healthcare facilities before adequate diagnoses are given that address their medical need, leading to significant financial expense, impact on land ownership and land as mechanism for income-generation, disruption to livelihood strategies and children’s educations, and inability to travel abroad as remittance workers. Findings have implications on healthcare-related financing and service care delivery in Nepal. (Less)
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author
Moroni, Matthew LU
supervisor
organization
alternative title
A case study on the implications of experiencing catastrophic health expenditure following acute medical need
course
UTVK03 20191
year
type
M2 - Bachelor Degree
subject
keywords
Nepal, healthcare, catastrophic health expenditure, out of pocket expenditure, social capital, identity
language
English
id
8989618
date added to LUP
2019-07-15 16:20:52
date last changed
2019-07-15 16:20:52
@misc{8989618,
  abstract     = {{Medical care in Nepal is largely financed by the individual, and although insurance programs and subsidies exist, they are limited in coverage, amount of assistance provided, and level of enrollment. Medical needs that extend beyond basic health services, specifically following acute injury can lead to financial difficulties that may jeopardize the ability to maintain basic needs and can push people into cycles of poverty. Costs for transportation, food, and itemized hospital charges can quickly deplete financial resources and require additional strategies to finance care, often through sale of land, loans, and forgoing of children’s educations. The aim of this study is to both understand strategies that are devised and utilized to finance healthcare following acute medical need and the implications of such strategies. To do so, a qualitative study was conducted in urban and rural Nepal among 10 individuals who experienced acute medical need and consequential high rate of healthcare-related spending. The theoretical framework that guided the study was based on theories of trust, including how trust is generated and exchanged, as well as theory on the male breadwinner, in order to conceptualize the role of men in Nepali society. Finally, theories on social capital, including its significance in enabling relationships between individuals within families and exchanges with members of patients’ local communities were utilized. Results indicate that patients often travel to multiple healthcare facilities before adequate diagnoses are given that address their medical need, leading to significant financial expense, impact on land ownership and land as mechanism for income-generation, disruption to livelihood strategies and children’s educations, and inability to travel abroad as remittance workers. Findings have implications on healthcare-related financing and service care delivery in Nepal.}},
  author       = {{Moroni, Matthew}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{Out-of-pocket Health Expenditure in Nepal}},
  year         = {{2019}},
}