Catastrophic Health Expenditure and Impoverishment of Syrian Refugees in Egypt

Abstract

The present study aims to measure the incidence and the concentration of catastrophic health expenditures, the impoverishment of  Syrian refugees living in Egypt due to health expenditures, and the determinants leading to catastrophic expenditures. This study used quantitative data, collected through a household health access and utilization cross-sectional telephone survey on Syrian households  registered with UNHCR Egypt. To estimate the incidence and intensity of catastrophic expenditures and impoverishment, the study used  two methods and applied various thresholds to demonstrate the sensitivity of catastrophic measures. A logit model was estimated aimed  at determining what factors influence the probability of catastrophic healthcare spending. 15.8% of the households spend > 30%  of nonfood expenditure in health care. Those spending more than 30% of non-food expenditure on health care spent 50.2% on average.  The fourth and richest quintiles experience a higher incidence of catastrophic expenditures. After pay-ing for health care the poverty  headcount increased 9.8 points, from 50 to 59.8%. The risk of incur-ring in catastrophic health expenditures increases with  unemployment, urban residency, hospitali-sation, pregnant woman, disability presence and when the household head is female. One out  of six refugee households experienced health expenditures in excess of 30% of non-food expenditures. Half of the Syrian Refugees in  Egypt leave below the poverty line and an additional ten percent, around 12,000 individuals, are pushed below the estimated poverty line  due to out-of-pocket health care payments.