Disparities in Out-Of-Pocket Expenditures among Hospitalized COVID-19 Patients: A Decomposition Analysis of Inequality

Abstract

Abstract Background and Aim: Little is known about the extent of inequality in OOP expenditures among COVID-19 patients and the factors contributing to it. This study aimed to examine the inequality in OOP expenditures among hospitalized COVID-19 patients and identify associated factors. Methods: The study employed the Gini coefficient as the primary measure of inequality in OOP expenditures among hospitalized COVID-19 patients. The analysis was conducted using Stata 16 software, supplemented by the Distributive Analysis Stata Package (DASP) extension. The Gini coefficient was calculated using these tools to quantify the degree of inequality and visualize it through graphs. To examine the Gini coefficient across population subgroups, the DASP extension, specifically the diginig module, was utilized. Results: The analysis of the Lorenz curve and the calculated Gini coefficient (0.69) confirmed the existence of inequality in OOP expenditures among hospitalized COVID-19 patients in this study. Furthermore, the examination of inequality across population subgroups revealed that the status and type of insurance coverage significantly contributed to the observed disparities in OOP expenditures among COVID-19 patients. However, the impact of other factors on inequality in OOP expenditures was found to be less prominent. Conclusion: The significant disparities observed in OOP expenditures, particularly related to the status and type of insurance coverage, emphasize the need for targeted interventions and programs aimed at reducing inequality in healthcare costs. Implementing initiatives to minimize financial burdens and promote equitable access to healthcare services can contribute to improved healthcare outcomes and alleviate the economic strain on patients.