The 1995/1996 Household Income, Expenditure - (PDF, 101 mb ...

VIII. 6
level, additional educational attainment affects medical expenditures negatively.
An intuitive interpretation is that additional education serves to keep the
household ever healthier. The coefficients on total expenditure suggest that 4
piasters of each additional £E spent by the household will go to medical goods
and services - in line with the overall budget shares. An unexpected and
significant finding is that additional household members are associated with
smaller overall medical expenditures - one additional member will decrease
medical expenditures 5.62 £E in 1990/1991 and 12.93 £E in 1995/1996 - this is
probably a combination of budget strain and household scale economies. We
will see a similar relationship (next section) of household size to per capita
medical expenditures. The regions having the lowest expenditures (the
numeraire is Cairo) are, expectedly, in Upper Egypt and the Frontier
governorates.
VIlLC 1995/1996 Household Average and Per Capita Medical Expenditures
Regional and household-size breakdowns of per capita expenditures on
medical goods and services in the recent survey (Tables VIIl.3 and VIllA)
point clearly to differential access based on geography. Per capita
expenditures on medical goods and services in the rural areas are only about
one-half what they are in urban areas. Not surprisingly, in average terms
the regional distribution of medical expenditures parallels the regional
distribution of total expenditures (see Table Il.3), and per capita expenditures
are similar. The budget shares shown in Table VIlL3 are different from the
shares shown above for two reasons: a) they are not equivalence-adjusted,
and b) they are formed as a less-biased ratio of sample-summed numerator
over sample-summed denominator instead of as an average of household-level
ratios (as above).
Both average and per capita expenditures for medical goods and
services fall over most of the curve as household members increase; there is a
point, after ten members, when both curves bend upward. As households
grow in size their members receive an ever declining share of medical
expenditures. Naturally the standard errors of the estimates in Table VIIlA
fall with the number of cases and rise with the number of household members
(keeping precise track of many expenditure sources being more complicated).
VIlLD Conclusion
Admittedly there are a number of extensions 2 to make to the analysis of
medical expenditures. A focus on the distribution of insurance payments
would serve to broaden the understanding of in-kind payments made to
employees, and would inform models correlating illness prevention with
incidence. In two other health related surveys in Egypt, the National
Household Health Care Utilization and Expenditure Survey, and the linked
Provider Survey, the Cairo Demographic Center and the Egyptian Ministry of
Health estimated that 70% of the surveyed population was not covered by any
2 Scott Moreland of the Population Project Consortium of Egypt (PPC)
suggested these classifications.