摘要：Objective To document the financial protection status of eight countries of the South-East Asian region and to investigate the main components of out-of-pocket expenditure on health care. Methods We calculated two financial protection indicators using data from living standards surveys or household income and expenditure surveys in Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste. First, we calculated the incidence of catastrophic health expenditure, defined as the proportion of the population spending more than 10% or 25% of their total household expenditure on health. Second, using World Bank poverty lines, we determined the impoverishing effect of health-care spending by households. We also conducted an analysis of the main components of out-of-pocket expenditure. Results Across countries in this study, 242.7 million people experienced catastrophic health expenditure at the 10% threshold, and 56.4 million at the 25% threshold. We calculated that 58.2 million people were pushed below the extreme poverty line of 1.90 United States dollars (US$) and 64.2 million people below US$ 3.10 (per capita per day values in 2011 purchasing power parity), due to out-of-pocket spending on health. Spending on medicines was the main component of out-of-pocket spending in most of the countries. Conclusion A substantial number of people in South-East Asia experienced financial hardship due to out-of-pocket spending on health. Several countries have introduced policies to make medicines more available, but the finding that out-of-pocket expenditure on medicines remains high indicates that further action is needed to support progress towards universal health coverage.
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