Abstract :
In middle-income Arab countries such as Egypt and Lebanon,
income-associated equity in health care remains an elusive policy objective in
part due to a relatively high reliance on out-of-pocket payments in financing
care. This article examines the effect of income on the use of outpatient and
inpatient health care services in Egypt and Lebanon using econometric analysis
of cross-sectional data from the World Health Organization. In light of
noticeable differences in income and public financing arrangements, these two
countries serve as interesting case studies. Multivariate regression results suggest
that Egyptian respondents were more likely to use health services than their
Lebanese counterparts, holding all else constant, and that this effect was
particularly evident for outpatient care. A higher income and insurance increased
the likelihood of outpatient use more so than inpatient use, with these effects
more pronounced in Lebanon. Overall, lower-income groups tended to report
having worse health levels and paying more out-of-pocket on health care as a
share of income than did higher-income groups. At the same time, these
socioeconomic disparities in health appeared to be greater in Lebanon than in
Egypt. Economic barriers to the use of health services are discussed within the
context of health financing policy reforms aimed at improving equity in access to
care in countries such as Egypt and Lebanon.
