The direct outlay of households, including gratuities and payments in kind, made to health practitioners and suppliers of pharmaceuticals, therapeutic appliances and other goods and services, whose primary intent is to contribute to the restoration or to the enhancement of the health status of individuals or population groups. Such expenditure includes household payments to public services, non-profit institutions and nongovernmental organizations, as well as non-reimbursable cost sharing, deductibles, co-payments and fee-for-service. It excludes payments made by companies that deliver medical and paramedical benefits, whether required by law or not, to their employees, and payments for overseas treatment. Expressed as percentage of private health expenditure.