"Background: Out-of-pocket expenses (OOP) refer to costs that individuals pay out of their own cash reserves. It includes both formal and informal expenses that are directly related to the cost of seeking care. There is an inverse relationship between the share of OOP in total expenditure of health care and being poor. Globally, more and more countries are adopting interventions to reduce OOP in health services.
Objective: The study aims to collect and present evidence on the effectiveness of all reported health interventions intended to reduce OOP.
Methods: The framework of this evidence and gap map is about intervention-outcome form. The interventions include free or subsidized public health, fee exemptions, free preventive health care, health financing, set price cap of health care service, and interventions to reduce unofficial payments. The outcomes include awareness and adoption of interventions, health service utilization, health service utilization, welfare outcomes. We will search PubMed, EMBASE, Web of Science, Scopus, Econlit, Cochrane Library, Campbell Collaboration, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, VIP database, and related grey literature database. We will include systematic reviews and primary studies. The quality of the included systematic reviews will be assessed using the AMSTAR-2 tool. Assess the primary studies using the critical appraisal tool developed by Howard and Saran. The tool consists of seven items, with four of them being crucial for decision-making. Each item will be assessed as having high confidence, medium confidence, or low confidence. The overall confidence in the study will be determined by the lowest rating among these four key items.
Results and Conclusions: This study is ongoing and results will be presented at Colloquium as available.
Funding: This work is supported by the Major Project of the National Social Science Fund of China (19ZDA142)."