Catastrophic Health Spending and Social Security Schemes for Elderly in Pakistan

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


increased longevity, reduction in fertility, and low coverage of health insurance
make the elderly vulnerable to high out-of-pocket (OOP) health payments and
catastrophic health expenditure (CHE). This chapter examines whether the out of-pocket health payment and catastrophic health expenditures increase with age and presence of elderly individuals in the household in Pakistan. Furthermore, it also explores whether the various social security schemes overcome the risk of CHE in household with elderly members. Data from the Household Integrated Economic Survey (HIES 2018–2019) is used in the analyses. Multivariate regression is used to examine the relationship between age and out-of-pocket health payments. The findings show that age is a significant predictor of OOP health payments. The monthly average OOP payment among elderly is 11 US$ compared to 7 US$ among the nonelderly. Similarly, the number of elderly individuals in the household is significantly associated with CHE. However, households with access to any of the society security schemes are, on average, 12–17% less likely to experience CHE. Increased public spending on health care facilities and provision of social safety net and health insurance programs can reduce the burden of OOP and catastrophic health payments in Pakistan.
Original languageEnglish
Title of host publicationHandbook of Aging, Health and Public Policy
PublisherSpringer Nature
ISBN (Electronic)978-981-16-1914-4
Publication statusPublished - 16 Mar 2022


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