Khouloud Khemiri
University Tunis Manar, Tunisia
Posters & Accepted Abstracts: Prim Health Care
Although evidence is available on the impact (or the evolution) of health care expenditure in developed countries, little empirical evidence has been reported for developing countries. This paper seeks to analyze and explain socio-economic related health expenditure inequalities in developing countries using the particular case of Tunisia before and after financial reform in 2007 marked by the established of the national fund of health insurance. Using the National Survey on household budget, consumption and standard of living; EBCNV, collected by the National Institute of Statistics (INS) in Tunisia in 2005 and 2010, we employed the decomposition of concentration index method to measure the socio-economic inequalities in health care expenditure; some need indicators and other control variables related to the inequality of the out-of-pocket health care expenditure in Tunisia are employed. Results show that the concentration index for socio-economic and need variables are significantly positive, they contribute deeply to produce more inequities of out-of-pocket health expenditure between 2005 and 2010. Furthermore, Tunisia still suffer from a deep inequalities issued by the demographic variables. Socio-economic and demographic variables contribute positively to deepen inequalities in health care expenditure. Contrary, need variables contribute, negatively, to increase inequalities in health care expenditure. Finally, elasticity of out-of-pocket expenditure relative to income and number of old people are positive but low. In conclusion, despite the general trends to reduce inequalities of health care spending among Tunisian households and improving equitable distribution of health care in Tunisia, the results still far from the desired objectives.
Khouloud Khemiri is member of Faculty of economics and management sciences, University Tunis Manar, Tunisia.
E-mail: khemiri.khouloud@gmail.com
