Assessing the burden of medical impoverishment by cause: a systematic breakdown by disease in Ethiopia

Abstract

This article, published in BMC Medicine, utilizes a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia (i.e., the number of households crossing a poverty line due to out-of-pocket (OOP) direct medical expenses). Among 20 leading causes of mortality, the authors estimate the burden of medical impoverishment to be around 350,000 poverty cases, with the top three causes of medical impoverishment attributed to diarrhea, lower respiratory infections, and road injury. In Ethiopia, medical impoverishment is found to be associated with illness occurrence and health services utilization. Although currently used estimates are sensitive to health services utilization, a systematic breakdown of impoverishment due to OOP direct medical costs by cause can provide important information for the design of health policies toward universal health coverage, reduction of direct OOP payments, and poverty alleviation.