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How Does the Introduction of Health Insurance Change the Equity in the Health Care Provision in Bulgaria?

  • Nora Markova
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    The study examines the effect of health care reform in Bulgaria in 1999 on the equity of health care financing. It explores the distribution of different types of health care financing by income. Furthermore, it separates the financial and social reasons for these differences, dividing them into economic and social inequalities. It suggests a method of distinguishing between financially based and "exclusion based" reasons for having progressive/regressive health care financing. Moreover, it looks at the social factors that shape health expenditure patterns and identifies those social characteristics that lead to exclusion from the health care system.

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    File URL: http://www.imf.org/external/pubs/cat/longres.aspx?sk=20043
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    Paper provided by International Monetary Fund in its series IMF Working Papers with number 06/285.

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    Length: 39
    Date of creation: 01 Dec 2006
    Date of revision:
    Handle: RePEc:imf:imfwpa:06/285
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    1. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income-related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628.
    2. Delcheva, Evgenia & Balabanova, Dina & McKee, Martin, 1997. "Under-the-counter payments for health care: Evidence from Bulgaria," Health Policy, Elsevier, vol. 42(2), pages 89-100, November.
    3. Minev, Duchomir & Dermendjieva, Bogdana & Mileva, Natasha, 1990. "The Bulgarian country profile: The dynamics of some inequalities in health," Social Science & Medicine, Elsevier, vol. 31(8), pages 837-846, January.
    4. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    5. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income-related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608.
    6. Erik SCHOKKAERT & Carine VAN DE VOORDE, 2000. "Risk Selection and the Specification of the Conventional Risk Adjustment Formula," Center for Economic Studies - Discussion papers ces0011, Katholieke Universiteit Leuven, Centrum voor Economische Studiƫn.
    7. Pavlova, Milena & Groot, Wim & van Merode, Godefridus, 2002. "Public attitudes towards patient payments in Bulgarian public health care sector: results of a household survey," Health Policy, Elsevier, vol. 59(1), pages 1-24, January.
    8. Kakwani, Nanak C, 1977. "Applications of Lorenz Curves in Economic Analysis," Econometrica, Econometric Society, vol. 45(3), pages 719-27, April.
    9. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    10. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    11. Uitenbroek, Daan G. & Kerekovska, Albena & Festchieva, Nevijana, 1996. "Health lifestyle behaviour and socio-demographic characteristics. A study of Varna, Glasgow and Edinburgh," Social Science & Medicine, Elsevier, vol. 43(3), pages 367-377, August.
    12. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    13. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
    14. Michael Marmot, 2001. "Income inequality, social environment, and inequalities in health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(1), pages 156-159.
    15. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
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