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Out-of-pocket payments, vertical equity and unmet medical needs in France: A national multicenter prospective study on lymphedema

Author

Listed:
  • Grégoire Mercier

    (CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], CEPEL - Centre d'Etudes Politiques de l'Europe Latine - UM - Université de Montpellier - CNRS - Centre National de la Recherche Scientifique)

  • Jenica Pastor

    (CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier])

  • Valérie Clément

    (MRE - Montpellier Recherche en Economie - UM - Université de Montpellier)

  • Ulysse Rodts

    (CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier])

  • Christine Moffat

    (UON - University of Nottingham, UK)

  • Isabelle Quéré

    (CHRU Montpellier - Hôpital Saint Eloi - CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], EA 2992 - Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires - UM1 - Université Montpellier 1 - UM - Université de Montpellier)

Abstract

Out-of-pocket payments might threaten the vertical equity of financing and generate unmet medical needs. The main objective was to assess the vertical equity of outpatient out-of-pocket payments for lymphedema patients in France. Twenty-seven centres, among which 11 secondary care hospitals and 16 primary care practices participated in this prospective national multicenter study. We measured the lymphedema-specific outpatient out-of-pocket payments over 6 months. The vertical equity of out-of-pocket payments was examined using concentration curves, the Gini coefficient for income, the Kakwani index, and the Reynolds-Smolensky index. We included 231 lymphedema patients aged 7 years or more, living in metropolitan France, and being able to use Internet and email. After voluntary health insurance reimbursement, the mean out-of-pocket payment was equal to 101.4 Euros per month, mainly due to transport (32%) and medical devices (26%). Concentration curves indicated regressivity of out-of-pocket payments. Total out-of-pocket payments represented 10.1% of the income by consumption unit for the poorest quintile and 3.5% for the wealthiest (p

Suggested Citation

  • Grégoire Mercier & Jenica Pastor & Valérie Clément & Ulysse Rodts & Christine Moffat & Isabelle Quéré, 2019. "Out-of-pocket payments, vertical equity and unmet medical needs in France: A national multicenter prospective study on lymphedema," Post-Print hal-02862217, HAL.
    • Handle: RePEc:hal:journl:hal-02862217
    DOI: 10.1371/journal.pone.0216386
    Note: View the original document on HAL open archive server: https://hal.umontpellier.fr/hal-02862217
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