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Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?

Author

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  • Marzena Tambor

    (Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland)

  • Jacek Klich

    (Department of Public Management, Cracow University of Economics, 31-510 Krakow, Poland)

  • Alicja Domagała

    (Department of Health Policy and Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland)

Abstract

After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care.

Suggested Citation

  • Marzena Tambor & Jacek Klich & Alicja Domagała, 2021. "Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?," IJERPH, MDPI, vol. 18(4), pages 1-26, February.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1382-:d:492173
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    References listed on IDEAS

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    1. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    2. Monika Karasiewicz & Ewelina Chawłowska & Agnieszka Lipiak & Barbara Więckowska, 2021. "A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting," IJERPH, MDPI, vol. 18(16), pages 1-18, August.
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    4. Katarina Vojvodic & Zorica Terzic-Supic & Jovana Todorovic & Cristina Gagliardi & Milena Santric-Milicevic & Marina Popovic, 2022. "Financial Burden of Medical Care, Dental Care, and Medicines among Older-Aged Population in Slovenia, Serbia, and Croatia," IJERPH, MDPI, vol. 19(6), pages 1-23, March.

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