Demographic and Welfare State Predictors of Out-of-Pocket Health Expenditures: A Path Analytic Model

Çınaroğlu S.

JOURNAL OF SOCIAL SERVICE RESEARCH, vol.44, pp.569-586, 2018 (SSCI) identifier

  • Publication Type: Article / Article
  • Volume: 44
  • Publication Date: 2018
  • Doi Number: 10.1080/01488376.2018.1477703
  • Journal Indexes: Social Sciences Citation Index (SSCI), Scopus
  • Page Numbers: pp.569-586
  • Keywords: Demographic indicators, welfare state, OOP health expenditures, Turkey, path analytic model, CARE EXPENDITURE, LOW-INCOME, SOCIOECONOMIC-STATUS, UNIVERSAL HEALTH, INSURANCE, TURKEY, POVERTY, PAYMENTS, COVERAGE, ACCESS
  • Hacettepe University Affiliated: Yes


Out-of-pocket (OOP) payments are principal components of financing healthcare and have a significant effect on poverty in numerous developing countries. The present study seeks to ascertain the relation among demographic, welfare state, and OOP health expenditure indicators using a path analysis. National representative household budget data from the Turkish Statistical Institute for 2015 were used. To test the goodness of fit of the model, multiple fit indices were utilized. The model fit for redefined path analytic model data was good (X-2/df = 70.20/9 = 7.8; RMSEA = 0.032; GFI = 1.00; AGFI = 0.99; CFI = 0.99). The results of the analysis revealed that demographic and welfare indicators are causally related to OOP health expenditures, and income was a mediating factor for this interrelationship. Designing of socially inclusive policies on the basis of the values of equity is essential to combat poverty due to OOP health expenditures in developing countries.