Chapter 8: What the ADePT Health Financing Module Does
payments as share of expenditure
Figure 8.1: Health Payments Budget Share and Cumulative Percentage of Households Ranked by Decreasing Budget Share
total catastrophic overshoot O
proportion H exceeding threshold
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cumulative percent of population, ranked by decreasing payment fraction Source: O’Donnell and others 2008.
curve and the threshold represents the total catastrophic overshoot. The “mean positive overshoot” is simply the average amount of overshoot among households overshooting the threshold. ADePT also gets at another possible concern of policy makers, namely, they might care more if the households experiencing catastrophic payments are poor than if they are rich. ADePT reports the concentration index for catastrophic payments, in which a negative value means that the households reporting catastrophic payments are largely poor ones. In addition, ADePT reports a weighted head count index that weights the degree to which a household exceeds the threshold by its position in the income distribution; it is the product of the head count and the complement of the concentration index. If the concentration index is negative, the weighted head count exceeds the unweighted head count. A policy maker who is averse to the poor disproportionately experiencing catastrophic payments might want to track the weighted head count rather than the unweighted one. ADePT undertakes the same exercise for the overshoot.
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