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Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

  • Petra Baji

    ()

    (Center for Public Affairs Studies Foundation Budapest Hungary
    Corvinus University of Budapest Health Economics and Health Technology Assessment Research Center Budapest Hungary
    Maastricht University Department of Health Services Research, CAPHRI; Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences Maastricht The Netherlands.)

  • Imre Boncz

    (University of Pécs Institute for Health Insurance Pécs Hungary)

  • György Jenei

    (Center for Public Affairs Studies Foundation Budapest Hungary
    Corvinus University of Budapest Health Economics and Health Technology Assessment Research Center Budapest Hungary)

  • László Gulácsi

    (Center for Public Affairs Studies Foundation Budapest Hungary
    Corvinus University of Budapest Health Economics and Health Technology Assessment Research Center Budapest Hungary)

The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public.

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Article provided by Akadémiai Kiadó, Hungary in its journal Society and Economy.

Volume (Year): 34 (2012)
Issue (Month): 2 (June)
Pages: 221-240

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Handle: RePEc:aka:soceco:v:34:y:2012:i:2:p:221-240
Note: The study is financed by the European Commission under the 7th Framework Program, Theme 8 Socio-economic Sciences and Humanities, Project ASSPRO CEE 2007 (Grant Agreement no. 217431). The content of the publication is the sole responsibility of the authors and it in no way represents the views of the Commission or its services.
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