The aim of this article is to measure the inequalities in healthcare utilization and financing due to the high out-of-pocket expenditure in the Tajik healthcare system. Despite the universality of its system, Tajikistan has one of the highest out-of-pocket rates in the world, ranging from 60% to 80% of expenditure, during the last decade. Based on data from the Tajikistan Living Standards Survey 2007 and on the methodology of concentration indices, we suggest that access to care is not equitably distributed in the population and that health expenditures are regressive. Informal payments simulated after controlling for differences in needs are also regressive. That result invalidates the hypothesis according to which doctors cross-subsidize.
JEL codes: I14, E26, D63.
- equity index
- healthcare service utilization
- healthcare financing
- index decomposition