Benefit Incidence Analysis

# Benefit Incidence Analysis

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## Benefit Incidence Analysis

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1. Benefit Incidence Analysis Abdo Yazbeck Lead Health Economist World Bank Institute Reaching the Poor Conference, February 24, 2004

2. Who benefits? \$ \$ \$ services

3. Benefit Incidence • A very crude but politically powerful way of measuring who is gaining from government spending • It simply combines two empirical facts: • Who is using the services • The cost to the government of making the services available • Data intensive

4. India BIA Source: NCAER, New Delhi, India

5. Strong Rural Inequality

6. By Level of Care

7. State-Level Findings:Benefit Incidence

8. Household Survey Data: Service Use Ability to group Out-of pocket payment (fees) Facility Cost Data: Unit cost of service delivery Ability to desegregate by level of care, type of service, and/or geographic location BIA Data Requirements

9. Steps • Group users by socioeconomic category • Income, sex, residence, tribe or caste, etc. • Determine service use by group • Calculate the unit cost for the service • Subtract the out-of-pocket fees from cost • Multiply the net unit cost by the group service use to determine group benefit

10. Vietnam Safe Motherhood • Examining the benefits from delivery and antenatal services by income group • Income groups are divided into five (quintiles) • Five service delivery levels in Vietnam: • Central Hospital • Provincial Hospital • District Hospital • Polyclinic • Commune Health Center

11. Benefit Incidence Math Total Benefit for each group = Utilization * Net Unit Cost.

12. Data by Income Group

13. Do the Math Hint: First calculate the delivery benefits, then calculate the benefits from antenatal visits, then add the two.

14. Utilization * Net Unit Cost • For Deliveries, the poor:225 * (511,000 – 71,773) = 98.8 Million • For Deliveries, the rich:741 * (511,000 – 60,734) = 333.6 Million • For antenatal care, the poor:(225*1.27)*(61,000-802) = 17.2 Million • For antenatal care, the rich: (741 *2.51)*(61,000-5,239) = 103.7 Million • Total, poor 98.8 + 17.2 = 116 MillionTotal, rich 333.6 + 103.7 = 437.3 Million

15. Results Question: What are possible policy implications of these findings?