Explore the vast range of titles available.

Financing incidence analysis (FIA) assesses how the burden of health financing is distributed in relation to household ability to pay (ATP). In a progressive financing system, poorer households contribute a smaller proportion of their ATP to finance health services compared to richer households. A system is regressive when the poor contribute proportionately more. Equitable health financing is often associated with progressivity. To conduct a comprehensive FIA, detailed household survey data containing reliable information on both a cardinal measure of household ATP and variables for extracting contributions to health services via taxes, health insurance and out-of-pocket (OOP) payments are required. Further, data on health financing mix are needed to assess overall FIA. Two major approaches to conducting FIA described in this article include the structural progressivity approach that assesses how the share of ATP (e.g. income) spent on health services varies by quantiles, and the effective progressivity approach that uses indices of progressivity such as the Kakwani index. This article provides some detailed practical steps for analysts to conduct FIA. This includes the data requirements, data sources, how to extract or estimate health payments from survey data and the methods for assessing FIA. It also discusses data deficiencies that are common in many low-and middle-income countries (LMICs). The results of FIA are useful in designing policies to achieve an equitable health system. L’analyse de l’incidence du financement (FIA) évalue comment la charge du financement de la santé est répartie par rapport à la capacité des ménages à payer (ATP). Dans un système de financement progressif, les ménages les plus pauvres contribuent une proportion plus faible de leur ATP pour financer les services de santé par rapport aux ménages plus riches. Un système est régressif lorsque, proportionnellement, les pauvres contribuent plus. Le financement équitable de la santé est souvent associé à la progressivité. Pour réaliser une FIA complète, il est nécessaire de disposer de données détaillées d’enquêtes auprès des ménages, avec des informations fiables à la fois sur une mesure cardinale de l’ATP des ménages et sur des variables, afin d’en extraire les contributions aux services de santé via les taxes, l’assurance-maladie et les paiements directs. En outre, pour évaluer la FIA globale, il est nécessaire de disposer de données relatives à toutes les sources de financement de la santé. Les deux approches majeures de la FIA décrites ici comprennent l’approche de la progressivité structurelle qui évalue comment la part de l’ATP (par ex. le revenu) dépensée pour les services de santé varie selon les quantiles; et puis l’approche de la progressivité effective qui utilise des indices de progressivité tels que l’indice de Kakwani. Cet article fournit quelques étapes pratiques détaillées pour les analystes souhaitant réaliser une FIA. Il s’agit entre autres des exigences en matière de données, de sources des données, de la manière d’extraire ou d’estimer les paiements de santé à partir des données d’enquête et des méthodes d’évaluation de la FIA. L’article traite également des carences en matière de données qui sont courantes dans de nombreux pays à revenu faible ou intermédiaire (PRFI). Les résultats de la FIA sont utiles pour concevoir des politiques visant à mettre en place un système de santé équitable. 筹资发生率分析 （FIA） 评估卫生筹资负担相对家庭支付能力 （ATP） 的分布。在发展的筹资体系中, 与较富裕家庭相比, 较贫困家庭的卫生服务支出占ATP的比例较小。而在退化的 体系中, 贫困家庭的支付比例更高。公平的卫生筹资通常与累 进度相关。为进行全面FIA, 需要详细的住户调查数据, 包括 家庭ATP的主要测量值, 以及计算卫生服务支出所需的纳税、 医疗保险和自付费用数据。此外, 还需要卫生筹资组合数据来 评估整体FIA。本文描述了两种主要的FIA方法, 包括结构累 进法, 评估用于卫生服务的ATP份额（如收入）如何随分层变 化；以及有效累进法, 采用卡瓦尼指数等累进度指数。本文为 研究者说明了进行FIA的详细步骤, 包括数据要求, 数据来源, 如何从调查数据中提取或估算卫生支出, 以及评估FIA的方 法。本文还讨论了许多中低收入国家 （LMICs） 普遍存在的 数据缺陷。FIA的结果有助于设计实现公平卫生体系的政策。 El análisis de incidencia de la financiación (AIF) evalúa cómo se distribuye la carga de la financiación de la salud en relación con la capacidad de pago (CDP) del hogar. En un sistema de financiación progresivo, los hogares más pobres contribuyen una proporción menor de su CDP para financiar los servicios de salud en comparación con los hogares más ricos. Un sistema es regresivo cuando los pobres contribuyen proporcionalmente más. La financiación equitativa de la salud es a menudo asociada con la progresividad. Para llevar a cabo un AIF exhaustivo, se requieren datos detallados de encuestas de hogares que contengan información confiable tanto sobre una medida cardinal del CDP de los hogares como sobre variables para extraer contribuciones a los servicios de salud vía impuestos, seguro de salud y pagos de bolsillo. Además, se necesitan datos sobre la combinación de la financiación de salud para evaluar el AIF general. Dos enfoques principales para llevar a cabo el AIF descritos en este artículo incluyen el enfoque de progresividad estructural que evalúa cómo varía la proporción de CDP (por ejemplo, ingresos) gastados en servicios de salud por cuantiles y el enfoque de progresividad efectiva que usa índices de progresividad como el índice de Kakwani. Este artículo proporciona algunos pasos prácticos detallados para que los analistas realicen el AIF. Esto incluye los requerimientos de datos, las fuentes de datos, cómo extraer o estimar los pagos de salud de los datos de la encuesta y los métodos para evaluar el AIF. También analiza las deficiencias de datos que son comunes en muchos países de ingresos bajos y medios (PIBMs). Los resultados del AIF son útiles en el diseño de políticas para lograr un sistema de salud equitativo

This Note argues that state legislatures should create statutory frameworks that permit judges to consider a defendant's ability to pay when determining the total amount of criminal restitution that should be ordered. Considering ability to pay before ordering restitution still accomplishes the goals of restitution while potentially increasing collection rates and managing victims' expectations. Further, this Note argues that judges should be able to consider a defendant's financial resources and ability to pay at subsequent proceedings in order to modify the defendant's restitution plan, or, alternatively, impose fair consequences based on the reason for their default on payment.

Background The relationship between payments towards healthcare and ability to pay is a measure of financial fairness. Analysis of progressivity is important from an equity perspective as well as for macroeconomic and political analysis of healthcare systems. Bangladesh health systems financing is characterized by high out-of-pocket payments (63.3%), which is increasing. Hence, we aimed to see who pays what part of this high out-of-pocket expenditure. To our knowledge, this was the first progressivity analysis of health systems financing in Bangladesh. Methods We used data from Bangladesh Household Income and Expenditure Survey, 2010. This was a cross sectional and nationally representative sample of 12,240 households consisting of 55,580 individuals. For quantification of progressivity, we adopted the ‘ability-to-pay’ principle developed by O’Donnell, van Doorslaer, Wagstaff, and Lindelow (2008). We used the Kakwani index to measure the magnitude of progressivity. Results Health systems financing in Bangladesh is regressive. Inequality increases due to healthcare payments. The differences between the Gini coefficient and the Kakwani index for all sources of finance are negative, which indicates regressivity, and that financing is more concentrated among the poor. Income inequality increases due to high out-of-pocket payments. The increase in income inequality caused by out-of-pocket payments is 89% due to negative vertical effect and 11% due to horizontal inequity. Conclusions Our findings add substantial evidence of health systems financing impact on inequitable financial burden of healthcare and income. The heavy reliance on out-of-pocket payments may affect household living standards. If the government and people of Bangladesh are concerned about equitable financing burden, our study suggests that Bangladesh needs to reform the health systems financing scheme.

The concept of participatory slum upgrading has received attention in the conventional literature because it ensures and promotes the sustainability of slum-upgrading programmes. In participatory slum-upgrading programmes, slum dwellers are treated as partners, instead of recipients of the services that are provided to mitigate their deprivations. The concept thrives on the willingness and ability of slum dwellers to pay for the services. The ability of slum dwellers to pay for services, unlike their willingness to pay, has received limited research attentions. Therefore, the purpose of this study was to assess the willingness and ability of residents of a slum settlement in Kumasi in Ghana to pay for utility services. Semi-structured interview schedules were used to gather primary data from a total of 276 households. The survey data were supplemented with data from key informant interviews and focus group discussions. The results show that almost nine out of every ten households were willing to pay for water and electricity services, if these services would be supplied to them directly by the state providers. The exploitation of the residents by unregulated utility services providers partly explains their willingness to pay for the utility services. These service providers charged almost 14 times the official tariffs. The results further show that all the households who were willing to pay were also capable of paying for the services without compromising their ability to afford other life essentials. The study concludes that slum regularisation policies, programmes and projects could be designed to be incremental and participatory by making the slum dwellers, partners and drivers of the upgrading process.

This paper uses new data from the PSID to quantify the relative importance of negative equity versus ability to pay, in driving mortgage defaults between 2009 and 2013. These data allow us to construct household budgets sets that provide better measures of ability to pay. Changes in ability to pay have large estimated effects. Job loss has an equivalent effect on the propensity to default as a 35% decline in equity. Strategic motives are also found to be quantitatively important, as we estimate more than 38% of households in default could make their mortgage payments without reducing consumption.

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.

To investigate the equity and policy implications of different methods to calculate catastrophic health spending. We used routinely collected data from recent household budget surveys in 14 European countries. We calculated the incidence of catastrophic health spending and its distribution across consumption quintiles using four methods. We compared the budget share method, which is used to monitor universal health coverage (UHC) in the sustainable development goals (SDGs), with three other well-established methods: actual food spending; partial normative food spending; and normative spending on food, housing and utilities. Country estimates of the incidence of catastrophic health spending were generally similar using the normative spending on food, housing and utilities method and the budget share method at the 10% threshold of a household's ability to pay. The former method found that catastrophic spending was concentrated in the poorest quintile in all countries, whereas with the budget share method catastrophic spending was largely experienced by richer households. This is because the threshold for catastrophic health spending in the budget share method is the same for all households, while the other methods generated effective thresholds that varied across households. The normative spending on food, housing and utilities method was the only one that produced an effective threshold that rose smoothly with total household expenditure. The budget share method used in the SDGs overestimates financial hardship among rich households and underestimates hardship among poor households. This raises concerns about the ability of the SDG process to generate appropriate guidance for policy on UHC.

Crowdfunding platforms have revolutionized entrepreneurial finance, with 200 billion dollars expected to be dispersed annually to entrepreneurs and small business owners by 2020 (2014 economic value of crowdfunding. http://www.crowdsourcing.org/editorial/crowdfunding-outlook-for-2014-and-beyond-infographic/30520, 2014). Despite the importance of this growing phenomenon, our knowledge of the dynamics of successful lending-based prosocial crowdfunding and its implications for the business ethics literature remain limited. We use a social responsibility lens to examine whether crowdfunders on a lending-based prosocial platform (Kiva) lend their money based on altruistic or strategic motives. Our results indicate that the dynamics of prosocial lending-based crowdfunding are somewhat consistent with traditional forms of financing. Specifically, despite a prosocial setting in nature, crowdfunders tend to act strategically, positively responding to signals of quality and low risk. Notably, we also find that projects that are high on both financial and social appeal receive the highest average amount of funding. Furthermore, language on the lender's profile indicating ability to pay is positively related to both funding success and funding amount. Our study contributes to filling the gap in the business ethics literature about the dynamics of lending-based prosocial crowdfunding, and the strategic and altruistic ethical motives that drive lenders in such endeavors.

This article uses a natural experiment to analyze whether incarceration during the pretrial period affects case outcomes. In Philadelphia, defendants randomly receive bail magistrates who differ widely in their propensity to set bail at affordable levels. Using magistrate leniency as an instrument, I find that pretrial detention leads to a 13% increase in the likelihood of being convicted, an effect largely explained by an increase in guilty pleas among defendants who otherwise would have been acquitted or had their charges dropped. I find also that pretrial detention leads to a 42% increase in the length of the incarceration sentence and a 41% increase in the amount of nonbail court fees owed. This latter finding contributes to a growing literature on fines-and-fees in criminal justice, and suggests that the use of money bail contributes to a “povertytrap”: those who are unable to pay bail wind up accruing more court debt.

The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively. The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs' HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.