Out-of-pocket (OoP) household health expenditures are among the most difficult factors to measure in the context of National Health Accounts (NHA). Yet their measurement is important: OoP household expenditures are typically the first or second largest source of health care financing in developing countries. Their incorrect measurement can undermine the credibility of total health spending estimates and thus NHA statistics, which are an otherwise important resource for policy makers. In most

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... ntries, private expenditures account for the biggest margin of error in national health spending estimates and represent the most substantial barrier to reliable international comparisons. Differences in accounting methods explain much of the discrepancy across nations. To further the academic investigation of this important issue, this paper focuses on OoP household health expenditures in Pakistan's NHA and suggests steps toward estimating such expenditures more effectively.