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Testing the Waters for GeSY: Patients’ Opinion of Cost-sharing Arrangements in the Public Health Care System in Cyprus

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  • Mamas Theodorou

    (School of Economics and Management, Open University of Cyprus)

Abstract

User charges constitute a common practice for most health policy makers, and are mainly used to discourage unnecessary demand and to generate extra revenues. Cyprus joined the group of countries with cost-sharing arrangements in August 2013, when user charges were imposed for some outpatient services. The objective of this study was to investigate Cypriot patients’ knowledge and understanding of a number of different co-payment aspects, to lead to useful policy considerations and recommendations for the future. A cross-sectional study was carried out, with a convenient sample of 885 patients who were beneficiaries of the public system, and data were collected using a structured questionnaire. The main results from multivariate logistic regression analysis indicate that a) lower income was associated with increased rates of those who judged the charges to be high or very high and of those who borrowed to pay the charges, b) as educational level dropped, a higher percentage considered the charges to be high or very high, and c) being male, being older and having a higher educational level were associated with increased percentages of those who agree that charges should be made for all health services. The experience of introducing co-payments in the healthcare system in Cyprus is valuable, and will be very useful for the upcoming implementation of the new General Healthcare Scheme (GeSY) that is likely to be accompanied by higher charges for patients. In this case it is apparent that patients’ opinions need to be considered, so as to lead to smarter planning, with evidenced based exceptions for certain vulnerable groups, and caps per month and user or family so as to avoid catastrophic and impoverishing effects.

Suggested Citation

  • Mamas Theodorou, 2014. "Testing the Waters for GeSY: Patients’ Opinion of Cost-sharing Arrangements in the Public Health Care System in Cyprus," Cyprus Economic Policy Review, University of Cyprus, Economics Research Centre, vol. 8(2), pages 37-59, December.
    • Handle: RePEc:erc:cypepr:v:8:y:2014:i:2:p:37-59
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    1. Cylus, Jonathan & Papanicolas, Irene & Constantinou, Elisavet & Theodorou, Mamas, 2013. "Moving forward: Lessons for Cyprus as it implements its health insurance scheme," Health Policy, Elsevier, vol. 110(1), pages 1-5.
    2. Akin, John S. & Guilkey, David K. & Hazel?Denton, E., 1995. "Quality of services and demand for health care in Nigeria: A multinomial probit estimation," Social Science & Medicine, Elsevier, vol. 40(11), pages 1527-1537, June.
    3. Elka Atanasova & Milena Pavlova & Emanuela Moutafovа & Todorka Kostadinova & Wim Groot, 2015. "Patient charges for health services: the opinions of healthcare stakeholders in Bulgaria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(3), pages 232-245, July.
    4. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    5. Hyehoon Lee, "undated". "The Effect of Health Insurance on Health Care Utilization," Discussion Papers in Public Sector Economics 95/3, Division of Economics, School of Business, University of Leicester.
    6. Cherkin, Daniel C. & Grothaus, Louis & Wagner, Edward H., 1992. "Is magnitude of co-payment effect related to income? Using census data for health services research," Social Science & Medicine, Elsevier, vol. 34(1), pages 33-41, January.
    7. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
    8. Martin Chalkley;Ray Robinson, 1997. "Theory and Evidence on Cost Sharing in Health Care: An Economic Perspective," Monograph 000429, Office of Health Economics.
    9. Evans, R.G. & Barer, M.L., 1995. "User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do with It?)," Centre for Health Services and Policy Research 95:8r, University of British Columbia - Centre for Health Services and Policy Research..
    10. Cockx, Bart & Brasseur, Carine, 2003. "The demand for physician services: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 22(6), pages 881-913, November.
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    Cited by:

    1. Petrou, Panagiotis, 2021. "The 2019 introduction of the new National Healthcare System in Cyprus," Health Policy, Elsevier, vol. 125(3), pages 284-289.
    2. Panagiotis Petrou, 2015. "An Interrupted Time-Series Analysis to Assess Impact of Introduction of Co-Payment on Emergency Room Visits in Cyprus," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 515-523, October.

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