Economic status and access to health care: An empirical study of Egypt and Lebanon.

Economic equality in health care continues to be a policy objective that is difficult to achieve in many countries. The aim of this thesis is to examine the effect of income level and health insurance status on the use of different health services in two contrasting funding systems, using the cases of Egypt and Lebanon. Although these countries share some similarities, they differ from one another with respect to income per capita and public financing systems. Due to these differences, it is hypothesised that the nature of economic barriers to access differs in each country. Methods used to examine the research question include descriptive and multivariate analyses of cross-sectional household survey data from the 2001 Multi-Country Survey Study, a survey conducted by the World Health Organization. Results from the analyses indicate that Egyptian respondents were more likely to use health services than their Lebanese counterparts, all other factors held equal. This result was especially evident in the case of outpatient care. Having a higher income level and health insurance were each associated with a greater likelihood of using health services, particularly for outpatient services as compared to inpatient services. These effects were also more pronounced in Lebanon. Lower-income groups tended to report worse health levels and higher out-of-pocket payments for health care as a share of income than did higher-income groups. Greater socioeconomic disparities in health were also found in Lebanon than in Egypt. This study shows that greater attention should be paid to the role of social safety nets in reducing inequalities, particularly for outpatient care