IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v92y2009i2-3p276-287.html
   My bibliography  Save this article

Hospital supplements in Belgium: Price variation and regulation

Author

Listed:
  • Lecluyse, Ann
  • Van de Voorde, Carine
  • De Graeve, Diana
  • Schokkaert, Erik
  • Van Ourti, Tom

Abstract

Objectives Although there is a comprehensive public health insurance system in Belgium, out-of-pocket expenditures can be very high, mainly for inpatients. While a large part of the official price is reimbursed, patients are confronted with increased extra billing (supplements). Therefore, the government imposed various restrictions on the amount of supplements to be charged, related to the type of room and the patient's insurance status. We investigate how prices are set and whether the restrictions have been effective.Methods We use an administrative dataset of the Belgian sickness funds for the year 2003 with billing data per hospitalisation and hospital characteristics. Boxplots describe the distribution of several categories of supplements. OLS is used to explore the relationship between hospital characteristics and extra billing.Results There is a large and intransparent variation in extra billing practices among different hospitals. Given the room type, supplements per day are smaller for patients qualifying for protection, confirming that the regulation is applied quite well. However, because of their longer length of stay this does not result in lower supplements per stay for these patients.Conclusions Currently the price setting behavior of providers lacks transparency. Protective regulation could be refined by taking into account the longer length of stay of vulnerable groups.

Suggested Citation

  • Lecluyse, Ann & Van de Voorde, Carine & De Graeve, Diana & Schokkaert, Erik & Van Ourti, Tom, 2009. "Hospital supplements in Belgium: Price variation and regulation," Health Policy, Elsevier, vol. 92(2-3), pages 276-287, October.
    • Handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:276-287
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(09)00102-X
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Herbert C. Northcott, 1982. "Extra-Billing and Physician Remuneration: A Paradox," Canadian Public Policy, University of Toronto Press, vol. 8(2), pages 200-206, Spring.
    2. Mitchell, Janet B. & Cromwell, Jerry, 1982. "Physician behavior under the medicare assignment option," Journal of Health Economics, Elsevier, vol. 1(3), pages 245-264, December.
    3. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395, April.
    4. Epp, Michael J. & Vining, Aidan R. & Collins-Dodd, Colleen & Love, Ernie, 2000. "The impact of direct and extra billing for medical services: evidence from a natural experiment in British Columbia," Social Science & Medicine, Elsevier, vol. 51(5), pages 691-702, September.
    5. McKnight, Robin, 2007. "Medicare balance billing restrictions: Impacts on physicians and beneficiaries," Journal of Health Economics, Elsevier, vol. 26(2), pages 326-341, March.
    6. van de Glind, Irene & de Roode, Stanny & Goossensen, Anne, 2007. "Do patients in hospitals benefit from single rooms? A literature review," Health Policy, Elsevier, vol. 84(2-3), pages 153-161, December.
    7. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
    8. Pauly, Mark V., 2000. "Insurance reimbursement," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 10, pages 537-560, Elsevier.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2023. "A model for dual health care market with congestion differentiation," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 32(2), pages 400-423, April.
    2. Brigitte Dormont & Mathilde Péron, 2016. "Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1073-1089, September.
    3. Deo, Sarang & Tyagi, Hanu & Chatterjee, Chirantan & Molakapuri, Himasagar, 2020. "Did India's price control policy for coronary stents create unintended consequences?," Social Science & Medicine, Elsevier, vol. 246(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brigitte Dormont & Mathilde Péron, 2016. "Does Health Insurance Encourage the Rise in Medical Prices? A Test on Balance Billing in France," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1073-1089, September.
    2. repec:dau:papers:123456789/15235 is not listed on IDEAS
    3. Hiroyuki Kawaguchi, 2012. "Unique mixtures of public and private funding in Japan - The ban on billing for mixed medical care service -," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 8(2), pages 145-170, July.
    4. Dormont, B. & Péron, M., 2015. "Does health insurance encourage the rise in medical prices?," Health, Econometrics and Data Group (HEDG) Working Papers 15/16, HEDG, c/o Department of Economics, University of York.
    5. Mathias Kifmann & Florian Scheuer, 2011. "Balance billing: the patients' perspective," Health Economics Review, Springer, vol. 1(1), pages 1-14, December.
    6. Christopher Brunt & Gail Jensen, 2010. "Medicare Part B reimbursement and the perceived quality of physician care," International Journal of Health Economics and Management, Springer, vol. 10(2), pages 149-170, June.
    7. Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2016. "Competition, prices and quality in the market for physician consultations," Journal of Industrial Economics, Wiley Blackwell, vol. 64(1), pages 135-169, March.
    8. Damien Besancenot & Karine Lamiraud & Radu Vranceanu, 2023. "A model for dual health care market with congestion differentiation," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 32(2), pages 400-423, April.
    9. McKnight, Robin, 2007. "Medicare balance billing restrictions: Impacts on physicians and beneficiaries," Journal of Health Economics, Elsevier, vol. 26(2), pages 326-341, March.
    10. Izabela Jelovac, 2015. "Physicians’ balance billing, supplemental insurance and access to health care," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 269-280, June.
    11. Elise Coudin & Anne Pla & Anne‐Laure Samson, 2015. "GP responses to price regulation: evidence from a French nationwide reform," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1118-1130, September.
    12. Nikos Nomikos & Panagiota Naoum & Vasiliki Naoum & Kostas Athanasakis & John Kyriopoulos & Elpida Pavi, 2022. "Individuals' personal characteristics associated with private health insurance policy possession in Greece," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 361-371, January.
    13. Jeffrey Clemens & Joshua D. Gottlieb & Jeffrey Hicks, 2021. "How Would Medicare for All Affect Health System Capacity? Evidence from Medicare for Some," Tax Policy and the Economy, University of Chicago Press, vol. 35(1), pages 225-262.
    14. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    15. Martin Gaynor, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-255, March.
    16. Carine Franc & Marc Perronnin & Aurelie Pierre, 2014. "Supplemental Health Insurance and Healthcare Consumption: A Dynamic Approach to Moral Hazard," Working Papers DT58, IRDES institut for research and information in health economics, revised Jan 2014.
    17. Pedro Pita Barros & Xavier Martinez‐Giralt, 2002. "Public and Private Provision of Health Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 11(1), pages 109-133, March.
    18. Denzil G. Fiebig & Kees van Gool & Jane Hall & Chunzhou Mu, 2021. "Health care use in response to health shocks: Does socio‐economic status matter?," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3032-3050, December.
    19. Sofia Vaz & Pedro Ramos, 2016. "Where did civil servants go? the effect of an increase in public co-payments on double insured patients," Health Economics Review, Springer, vol. 6(1), pages 1-8, December.
    20. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:276-287. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.