Journal article

The impact of user charges on health outcomes in low-income and middle-income countries: a systematic review

Vicky Mengqi Qin, Thomas Hone, Christopher Millett, Rodrigo Moreno-Serra, Barbara McPake, Rifat Atun, John Tayu Lee

BMJ Global Health | BMJ PUBLISHING GROUP | Published : 2018

Abstract

Background: User charges are widely used health financing mechanisms in many health systems in low-income and middle-income countries (LMICs) due to insufficient public health spending on health. This study systematically reviews the evidence on the relationship between user charges and health outcomes in LMICs, and explores underlying mechanisms of this relationship. Methods: Published studies were identified via electronic medical, public health, health services and economics databases from 1990 to September 2017. We included studies that evaluated the impact of user charges on health in LMICs using randomised control trial (RCT) or quasi-experimental (QE) study designs. Study quality was ..

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